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 provided. 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”), the undersigned guarantor(s) (“Undersigned”) jointly, unconditionally and irrevocably guarantees to City Rent A Truck the full and prompt payment, performance and satisfaction by Customer of each and every one of its obligations to City Rent A Truck LLC (“City Rent A Truck”), whether now in existence or arising on or after the date of this Guaranty whether absolute or contingent, and whether secured or unsecured, together with all fees and charges of whatsoever kind and nature arising therefrom or relating thereto. The Undersigned further agrees to indemnify City Rent A Truck and hold it harmless from any loss, cost or expense (including, without limitation, reasonable attorney’s fees and other costs of collection) arising from or as a result of any breach by Customer of its obligations to City Rent A Truck or any breach by the Undersigned of Undersigned’s obligations under this Guaranty.

The Undersigned hereby waives waives demand for payment under this Guaranty, protest, presentment, any applicable homestead exemption(s), notice of acceptance of this Guaranty, all set-offs and counterclaims; and (e) all other notices customarily given and/or to which the Undersigned would otherwise be entitled. It is expressly understood that City Rent A Truck will not be required to exhaust its legal remedies for recovery against Customer before seeking payment from the Undersigned and that the Undersigned is obligated, absolutely and immediately, to pay any amount owed to City Rent A Truck by Customer and/or to perform any obligation due to City Rent A Truck by Customer immediately upon Customer’s failure to timely pay or perform. This is intended to be, and is, a continuing Guaranty applying to all transactions effected or to be effected, between City Rent A Truck and Customer and shall not be revoked by the Undersigned except upon the receipt of written notice via certified mail with proof of delivery by City Rent A Truck from the Undersigned, addressed to the attention of City Rent a Truck's general counsel, to not enter into further agreements with Customer on the security of this Guaranty. Such revocation will only be effective with respect to any obligations by Customer arising after the date such written revocation was received by City Rent A Truck.

This Guaranty is governed by the laws of the State of Missouri, without regard to conflict of laws principles. The undersigned and City Rent A Truck agree that any judicial proceeding to resolve claims relating to this Guaranty will be brought in the federal or state courts of Platte County, Missouri. Both the Undersigned and City Rent A Truck consent to venue and personal jurisdiction in such courts. The Undersigned further agrees and authorizes City Rent A Truck to investigate Undersigned’s credit and financial information through any credit bureau or any other reasonable means including direct contact with past and present creditors. The Undersigned has caused this Guaranty to be executed on the date set forth below.
Guarantor's Signature

Clear
Guarantor's Name Printed

First NameLast Name
Guarantor's Social Security Number
Date

MonthDayYear

Submit Application
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Commercial Business Application

Reference 1

Reference 2