Platinum Metals - Onboarding

13830 Grabill Rd, Grabill, IN 46741 | 260-627-9060

FOR PURCHASE ORDER GOODS AND SERVICES WITH PLATINUM METALS, LLC

Customer / Client / Contractor*

e.g. Business Name

Authorized Representative*

Full Name

Contact Phone Number*

Please enter a valid phone number.

Contact Email*

example@example.com

Years in Business*

Contact Business Address*

Street Address

Street Address Line 2

CityState

Zip Code

Business References

Reference 1: Business Name*

Reference 1: Phone Number*

Please enter a valid phone number.

Reference 1: Email*

example@example.com

Reference 2: Business Name*

Reference 2: Phone Number*

Please enter a valid phone number.

Reference 2: Email*

example@example.com

Reference 3: Business Name

Reference 3: Phone Number

Please enter a valid phone number.

Reference 3: Email

example@example.com

Your Purchase Order(s) and Invoicing for Platinum Metals, LLC’s Goods and Services has been confirmed as stated under the following Terms and Conditions:

You will be billed on a monthly basis for all future Goods and Services initiated by your business, entity, company, or authorized representative doing business as a customer, client, or contractor of Platinum Metals, LLC. All Purchase Order(s) and Invoicing will include all itemized statements of Goods and Services within the monthly statement(s).
You agree to review our itemized statements promptly upon receipt and to notify me within ten (10) days if you dispute or question any Purchase Order(s) and Invoicing item(s) set forth on the itemized statement. If you fail to notify me regarding any disputed item within ten (10) days of receipt of the itemized statement, the amount will be due as owing and an account will be stated. All balances on your account are due within thirty (30) days after the date of the itemized statement.
If you do not pay your account when due, Platinum Metals, LLC has the right, at our discretion, to file a lien on the total account stated with accrued collection costs and interest for any work or job(s) completed with the Purchase Order(s) and Invoicing item(s) used. Said lien will secure the balance on the total account stated
and owing as of the date filed.
You agree that any unpaid balance outstanding for thirty (30) days or more will accrue interest at the rate of eight percent (8%) per annum. Further, if we are required to refer your account to an attorney for collection, you agree that you will also be responsible for all court costs, expenses incurred, reasonable attorney's fees, and all other reasonable collection costs and expenses with bringing a civil action enforceable under Indiana law within the jurisdiction and venue of the Allen Circuit and Superior Courts in Allen County, Indiana.

By signature below, I understand and acknowledge all Terms and Conditions agreed. I have read the above and foregoing agreement, understand the contents of the same, and agree to all of the Terms and Conditions. Further, as the representative individual(s) executing this statement of Terms and Conditions, I represent(s) and certify(certifies) on behalf of the customer, client, or contractor of Platinum Metals, LLC, that I have been fully empowered by the organizational and governing documents of the customer, client, or contracting business entity, to execute and deliver this statement of Terms and Conditions, that the customer, client, or contractor of Platinum Metals, LLC is an entity in good standing in the State of its origin and, where required, in the state of Indiana; that the customer, client, or contractor of Platinum Metals, LLC has full legal capacity to engage and enter into the Terms and Conditions for Goods and Services of Platinum Metals, LLC, as well as an account stated, as described; and that all necessary action and undertaking by the customer, client, or contractor of Platinum Metals, LLC has been duly taken.

Today's Date*

Date

EIN / FEDERAL ID #

Required in order to provide tax exemption sales & services.

Authorized Representative Signature*

Business Name

Phone Number

Please enter a valid phone number.

Email

example@example.com