Credit Application | Carolina Food Service of Loris

Customer Credit Application

Fill out the form below to receive credit approval through Carolina Food Service. Once you've completed the credit application form, you'll be notified of your approval status. Have questions or need help? Contact the Carolina Food Service team.
Customer Information
Territory Sales Manager: *
Business Name:*
Business Phone: *
Fax:
Email Address: *
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Federal Tax ID*
Resale Tax ID*
Entity Type*

CorporationProprietorshipLLCOther
Year Established:
State of Incorporation: *

Names of Principal Officers, Partners, or Owners

Primary Contact Info
Name: *
Title:*

OwnerBuyerPayables
Phone:*
Email:*
Social Security Number (or ITIN): *
Driver License Number: *

Contact #2
Name:
Title:

OwnerBuyerPayables
Phone:
Email:
Within the last five (5) years has the applicant, or principle owners of the applicant, been sued by a trade creditor, or filed a petition under any Chapter of the Bankruptcy Code?*

YesNo

Trade References

Reference #1
Company Name: *
Contact Person: *
Address: *
Phone: *
Fax:
Email: *

Reference #2
Company Name:
Contact Person:
Address:
Phone:
Fax:
Email:

Bank Reference
Bank Name: *
Account Number: *
Account Type*

CheckingSavings
Bank Phone:
Bank Address:
Account Officer:
Email:
I (We) understand that the information furnished to you in the previous page hereof is for the purpose of obtaining credit from your company, that I am (we are) authorized, in my (our) capacity, to bind my (our) company accordingly, and I (we) authorize Carolina Food Service of Loris to investigate all our trade and banking references solely for the purpose of this credit application and that it will be used to determine credit applicability.*

I agree
The person signing the credit application on behalf of the Applicant attests that is within his/her authority to open this business account and to request credit from Carolina Food Service of Loris according to the application and further agrees to be personally liable for any indebtedness owing at any time to Carolina Food Service of Loris in the event such Applicant should disavow such authority.
Signature*

Clear
Date*

MonthDayYear

Terms and Conditions
Initial Orders:

All initial sales orders are accepted on a C.O.D. basis until a credit account has been approved setting both a credit limit and payment terms.
Invoice and Statement:

Each order is printed on a computer form which also serves as an invoice for the sale and is sent when product is being shipped. It will be due on the terms we stipulate in your credit approval letter. In addition to the invoice, a statement is mailed to credit accounts with open balances once a week.
Claims - Waiver:

Any product disputes must be submitted by the Customer in writing within twenty-four (24) hours of receipt of product. All products judged to be defective by Customer must be returned to Carolina Food Service of Loris before replacement is made or credit issued unless other arrangements are made with Carolina Food Service of Loris.Customer agrees to notify Carolina Food Service of Loris of any returns or product defectiveness in a timely manner which constitutes a claim for credit. Otherwise, any such claim is waived by Customer and Carolina Food Service of Loris shall have no obligation to make any adjustment, credit or cash refund. All such notifications should be made to the respective salesperson.
Customer Obligations:

Customer agrees to pay all invoices when due and not to exceed their credit limit. If customer fails to make a payment on its account in a timely manner or if any invoice remains unpaid for more than thirty (30) days, Carolina Food Service of Loris, at its option, may, at any time thereafter, defer the performance of any further sales and/or decrease Customer’s credit limit or payment terms. Customer further agrees to pay all costs and expenses, including attorney fees, incurred by Carolina Food Service of Loris with respect to the collection of any unpaid balance, whether or not litigation is commenced.Customer agrees to pay a fee of thirty dollars ($30.00) or highest amount permitted by law for any returned items (checks or ACH) that are dishonored for any reason.Should customer dispute any portion of any invoice or statement, undisputed portions of the same and other invoices not in dispute, shall never-the-less be paid when due without offset.
Signature*

Clear
Date*

MonthDayYear
Name*

First NameLast Name
Should be Empty:

Customer Credit Application

Customer Information

Names of Principal Officers, Partners, or Owners

Trade References

Bank Reference

Terms and Conditions

Initial Orders:

Invoice and Statement:

Claims - Waiver:

Customer Obligations: