Commercial Business Application

Commercial Business Application

Customer information
City Rent a Truck Sales Representative Name*
Enter the name of the Sales Representative you spoke with.
City You Need Trucks In*
Length of Rental*
If Monthly - how many months?
Business Legal Name*
The Registered name of your Business.
DBA
The name you do business as if different than your legal business name.
DOT #
Industry*
If Other Please Type in Your Industry*
Industry
Contact Name*

First NameLast Name
Type of Business*
Federal Tax ID*
FEIN or SSN if individual
Business Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Time in Business*
State of Organization*
Number of Fleet Vehicles Currently Operated*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Gross Annual Revenue
Has this company, its owners, or officers ever filed for bankruptcy?*

YesNo
Sales Tax Exempt?*

YesNo
Tax-Exempt Form

If your company is exempt from sales tax, please submit your tax-exempt form here.
Cancelof

Billing Information
Accts Payable Contact*

First NameLast Name
Accts Payable Phone *

Area CodePhone Number
Accts Payable Email*
example@example.com
PO Required?

YesNo
Job Name/# Required?

YesNo
Monthly Statements Required?

YesNo
Name (as it appears on card):
Cardholder Name
CARD INFORMATION: download this fillable PDF and re-attach in the next field or email it to dbowman@cityrentatruck.com.
CC Authorization Form

Please Attach Your filled out CC Auth Form Here
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Principal 1 Information
Name

First NameLast Name
Title
Phone

Area CodePhone Number
Home Address (No PO Box)

Street Address

Street Address Line 2

CityState

Zip Code
Social Security Number
US Citizen?

YesNo
% Ownership

Insurance Attestation
Certificate of Commercial Insurance*

Please attach your companies Certificate of Insurance, not your insurance card.
Cancelof
Insurance Attestation*

City Rent A Truck LLC is an additional insured on the auto liability insurance noted above. Auto liability shall be primary and non-contributory. Waiver of subrogation applies in favor of City Rent A Truck LLC on the auto liability noted above. Pursuant to rental agreement, all vehicles rented from City Rent A Truck LLC are insured on the commercial auto policy noted above for comprehensive and collision physical damage equal to the value shown in the rental agreement. With regards to physical damage on a rented truck, City Rent A Truck shall be listed as a loss payee.
Insurance Company
Insurance Contact
Contact Phone

Area CodePhone Number
Contact Email
example@example.com

Bank & Lending References
Bank/Lender Name*
Bank/Lender Phone *

Area CodePhone Number
Account#*
Bank/Lender Contact Name*
Type Account*

SavingsCheckingLoanLine of Credit

Trade References
Reference 1
Company Name*
Company Contact*
Email*
example@example.com
Fax *
Please enter a valid fax number if no email address is known.
Reference 2
Company Name
Company Contact
Email
example@example.com
Fax
Please enter a valid fax number if no email address is known.

Terms & Conditions
By applying herein for credit with City Rent A Truck LLC ("City Rent A Truck"), Applicant agrees that this application is the property of City Rent A Truck and expressly authorizes City Rent A Truck to investigate Applicant’s credit and financial information through any credit bureau or any other reasonable means including direct contact with past and present creditors. Applicant understands that City Rent A Truck's payment terms are based on credit quality, and agrees to pay all invoices according to these terms granted, based on the information provide. Applicant further understands that all past due accounts are subject to a 1.5% Finance Charge on all invoices 30 days or more past due, which is an annual percentage rate of 18% and agrees to pay such charges according to these terms along with all costs of collection, including reasonable attorney’s fees incurred by City Rent A Truck in collecting any past due balance. Applicant expressly consents to City Rent A Truck protecting its lien rights including, but not limited to, by filing preliminary notices for work done in states where such notices are required. Applicant further agrees to be bound by City Rent A Truck's standard form rental contract in use at the time of each rental transaction, the terms and conditions of which are incorporated into this Credit Application in their entirety, regardless of whether executes such rental contract.
Do you agree to the terms & conditions?*

Yes I agree to the terms & conditions
Signature*

Clear
Printed Name*
Title*
Date

MonthDayYear

Personal Guaranty
In consideration of the extension of credit to ("Customer"),
Guarantor's Signature

Clear
Guarantor's Name Printed

First NameLast Name
Guarantor's Social Security Number
Date

MonthDayYear

Submit Application
How did you hear about us?
City a Rent Truck is committed to protecting and respecting your privacy. We’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you.

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Commercial Business Application

Reference 1

Reference 2