GECS Credit Application

Application for Credit
This application is to apply for NET 30 credit terms with Gary's East Coast Service, Inc.

Filling out this application does not automatically give credit approval.

Please allow 2-5 business days for processing. You will receive an email with approval or denial status.

If you need service immediately, please arrange for payment to be made available at the time of service.
Credit Application Contact

Please let us know who we should contact for Credit Application questions and approval status
Name

First NameMiddle NameLast Name
Title
Email
Phone
If you have questions, please contact service@garyseast.com or 203-922-1000
Utilize the "SEND DRAFT LINK" button to finish this application at a later time or forward it to another individual for completion.
If you would prefer to mail back a physical copy of this form, please call the office.
Gary's East Coast Service, Inc.

91 Willenbrock Rd • Suite B-1 Box 5

Oxford CT 06488

203-922-1000 • www.garyseast.com

Business Information
Legal Company Name
DBA
Business Category
Other
Type of Business
Established in the state of
Month/Year Established
Federal ID Number
D&B Number
Are you tax-exempt in CT, MA, or NY?
Please upload your tax-exempt form(s)

Please upload appropriate tax forms for each applicable state. See below for Tax-Exempt Requirements
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- To be set up as exempt from tax you must be registered as tax-exempt with the state you are looking to have service performed. Please see below for additional forms that may be required depending on the state and your company's exemption category.
  
  Connecticut
  - Qualifying Exempt Organizations - must upload a CERT-119 Form dated 3 years or less
  - Governmental Agencies - must upload a CERT-134 Form dated 3 years or less
  - Nonprofit Charitable Hospital, Nonprofit Nursing Home, Nonprofit Rest Home, or Nonprofit Residential Care Home - must upload a CERT-113 Form dated 3 years or less
  - Sales and Use Resale - must upload a CT Sales & Use Form dated 3 years or less
  Massachusetts
  - Government Agencies and other Qualifying Exempt Organizations - must upload your ST-5 Form
  - Sales and Use Resale - Must upload your ST-4 Form
  New York
  - Government Agencies and other Qualifying Exempt Organizations - must upload your exemption certificate
  - Sales and Use Resale - Must upload ST-120 Form
  Other Exemption Statuses
  
  If your organization holds a tax exemption status other than what is listed above, please upload your certificate for our review.
- Business Owner Information
- Please add all individuals, partners, owners, and/or officer information

Credit References

Please upload your company's Credit Reference Sheet or Manually enter your company's credit references by selecting from the two options below. These Credit References should be accurate and current. By providing contact information, you are authorizing Gary’s East Coast Service to contact your trade references or bank references.
Please upload your company's Credit Reference Sheet

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Service Location Information
Service Location(s)
Please upload a list of Service Locations with their Contact Information

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Please add any site information that our dispatchers or technicians may need
Ex: "Enter by Side door," "See manager for entry," "Site hours 8am-3pm daily," etc.

Invoicing Information
Bill to Address
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How would you like to receive your invoices?
Email Invoices
Please add any emails that should receive a copy of the invoice
Does your Accounting Dept require an Authorization Number for service calls placed to Gary's East Coast Service?
Example: a Purchase Order (PO), Work Order Number, etc. If you check this box our team will ask for a PO when service calls are placed
Invoicing Instructions
Estimate Information
Estimate Email(s)
If you need an estimate created, these are the email(s) we will use
Not to Exceed (NTE) Requirements
Any "not to exceed" dollar amount required before an estimate is needed (applicable for on-site jobs and parts or parts to order)
Service Agreements
Other
If applicable, please upload any Service Agreements, Requirements or Contracts that you may require of Gary's East Coast Service for our review

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Accounts Payable Information
Name

First NameMiddle NameLast Name
Title
Email
Phone
Additional Information

Pricing Policy
Thank you for considering our services. We strive for transparency and communication with our customers, so we have outlined our pricing policy below for your review.

We value the time and expertise of our technicians, and as such, we do not provide free estimates. All labor time, including diagnostic time for equipment not repaired, will be charged accordingly. We believe that our pricing is competitive and reflective of the high-quality service that we provide.

Our Current Labor Rate during regular business hours includes time spent onsite and travel one way from our office in Oxford, CT. Mileage is charged at a flat fee depending on your location.

We do offer emergency service outside of our regular business hours. Our Emergency Labor Rates are charged at Overtime or Doubletime. Service after regular business hours and Saturdays is charged at our Overtime Rate. Sundays and Holidays charged at our Doubletime Rate.

Emergency service will incur travel charges both ways from/to our office in Oxford, CT and mileage.

Labor Rates (Subject to Change Without Notice):

Regular Business Hours: $170/hr (CT & MA), $200/hr (NY)
Overtime: $255/hr (CT & MA), $300/hr (NY)
Sundays & Holidays: $340/hr (CT & MA), $400/hr (NY)
Mileage: Charged for NY and MA services

Our Minimum Charge is one hour of labor. If you need to cancel service, please inform us beforehand. However, if a technician has already been dispatched to your location, you will incur a charge.

Pricing is subject to sales tax in the state the service is performed, unless a valid tax exempt certificate is on file prior to service.

Payments we accept are cash, checks, ACH, as well as credit/debit payments via our website. It is your responsibility to pay with your card through our website at garyseast.com/pay. Please note that we will never hold your card on file or take your card information over the phone.

If we are dispatched for equipment that is still under manufacturer warranty, we must adhere to the manufacturer's guidelines, including their non-warranty procedures. If a service call is deemed a non-warranty issue, you will be responsible for paying for the incurred service.

If you have any questions or concerns please do not hesitate to contact us.
An Owner, Partner, or Officer must sign

Signing indicates that you understand and agree to the above Pricing Policy.
I have read and understand the pricing policy above and agree to pay for service and parts billed according to the policy. I further understand this is not an extension of credit and my bill is due in full upon completion of service, unless a current and approved Application for Credit has been processed for my account.
Signature*

Full Name*

Title* Date*
Signature

    Full Name

Title    Date

Payment Terms
By signing this application, the undersigned agrees to the following:
1. Should Gary’s East Coast Service, Inc. approve this application,I/we agree to pay for all goods and services purchased within 30 days of the date of invoice.
2. Gary’s East Coast Service, Inc. is authorized to contact any trade references or bank references listed above. It is understood that any information so obtained will be used solely for granting credit.
3. Service charges at the highest rate permitted by state law will be applied to past-due accounts.
4. Should it become necessary to collect this account by legal proceeding or otherwise, the undersigned including endorsers, promise to pay all costs of collection, including a reasonable attorney’s fees.
An Owner, Partner, or Officer must sign

Signing indicates that you understand and agree to the above Payment Terms.
Signature*

     Full Name*

Title* Date*
Signature

Full Name

Title    Date
Individual Personal Guarantee

Please fill out the fields below to populate the Personal Guarantee
Name

First NameMiddle NameLast Name
Social Security No.
Residing Street Address
Residing Town
Residing State
Title
Personal Guarantee

I, {name260}, residing at {residingStreet},{residingTown} in the state of {residingState} for and in consideration of Gary's East Coast Service, Inc. extending credit at my request to {legalCompany22} (Hereinafter referred to as the “company”), of which I am {title}, Hereby personally guarantee to you the payment of any obligation of the Company and I hereby agree to bind myself to pay Gary’s East Coast Service, Inc. on demand any sum which may become due to Gary’s East Coast Service, Inc. by the Company whenever the Company shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable guarantee and indemnity for such indebtedness of the Company. I do hereby waive notice of default, non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guaranteed.
Signature Date
Social Security No: {socialSecurity}
Individual Personal Guarantee

Please fill out the fields below to populate the Personal Guarantee
Name

First NameMiddle NameLast Name
Social Security No.
Residing Street Address
Residing Town
Residing State
Title
Personal Guarantee

I, {name261}, residing at {residingStreet244}, {residingTown245} in the state of {residingState246} for and in consideration of Gary's East Coast Service, Inc. extending credit at my request to {legalCompany22} (Hereinafter referred to as the “company”), of which I am {title247}, Hereby personally guarantee to you the payment of any obligation of the Company and I hereby agree to bind myself to pay Gary’s East Coast Service, Inc. on demand any sum which may become due to Gary’s East Coast Service, Inc. by the Company whenever the Company shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable guarantee and indemnity for such indebtedness of the Company. I do hereby waive notice of default, non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guaranteed.
Signature Date
Social Security No: {socialSecurity243}

Review and Submit Application for Credit
Application for Credit

Please allow 2-5 business days for processing.

You will receive an email with approval or denial status for your Application for Credit to the email address below (provided on the first page).

Once submitted, you will also recieve a copy of your application for your records.

Application for Credit Contact

{name258}

{email151}

Questions can be sent to service@garyseast.com or 203-922-1000

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Utilize the "SEND DRAFT LINK" button to finish this application at a later time or forward it to another individual for completion.

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To Submit, please click the "REVIEW APPLICATION" button. Note: all required field must be filled out before the review page generates
Please verify that you are human
Gary's East Coast Service, Inc.

91 Willenbrock Rd • Suite B-1 Box 5

Oxford CT 06488

203-922-1000 • www.garyseast.com
Should be Empty:

Rows	Name	Address	City, State, Zip	Phone	Email	Account #
Bank Reference
Trade Reference 1
Trade Reference 2
Trade Reference 3

Application for Credit

Credit Application Contact

Business Information

Business Owner Information

Credit References

Service Location Information

Invoicing Information

Email Invoices

Estimate Information

Service Agreements

Accounts Payable Information

Pricing Policy

An Owner, Partner, or Officer must sign

Payment Terms

An Owner, Partner, or Officer must sign

Individual Personal Guarantee

Individual Personal Guarantee

Review and Submit Application for Credit