Property Account Credit Activation Form
Date
*
-
Month
-
Day
Year
Salesperson
Branch Location
*
Please Select
22 - Orlando
122 - Jacksonville
Property Name
*
Number of Units
*
Year Built
*
Managed Type
*
Fee Managed
Owner Managed
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Managers Name
*
Phone Number
*
Email
*
example@example.com
Billing Contact (A/P)
*
Phone Number
*
Email
*
example@example.com
Property Management Information
Property Management Company
*
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Owner Information
Legal Name or Entity that owns this Property
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Structure (check one)
*
Corporation
Sole Proprietorship
Partnership
LLC
LP
Ordering and Billing Information
Purchase Order Required
*
Yes
No
Tax Status (**if tax exempt, a copy of the exemption is required)
*
Taxable
Exempt
Payment Method
*
ACH (preferred)
Check
Other
Send Invoices To (check all that apply)
*
Property
Management Company
Owner
3RD Party
Email address for billing purposes
*
can list more than one
If 3rd party please check one
Ops Technology
Yardi Cafe
Nexus
Other
Credit Line Desired: $
*
Trade References
Company Name
*
Contact
*
Phone Number
*
Email
*
example@example.com
Company Name
Contact
Phone Number
Email
example@example.com
Upon the earlier of (a) the date indicated on this account activation form or (b) my (our) acceptance of services or goods from Impact Property Solutions(Impact Property Solutions), I hereby agree and represent as follows: (i) if I am delivering this account activation form on behalf of a company or other legal entity, I have the authority to bind such entity to the terms and conditions of this form, (ii) the information furnished on this form is true and correct in all respects, (iii) I (we) hereby deliver this form to Impact Property Solutions, including, without limitation, for the purpose of obtaining a credit account with Impact Property Solutions and Impact Property Solutions may rely on all information set forth herein, (iv) I am (we are) authorized to bind the applicable owner(s) of the property or properties to which the goods and services contemplated hereunder relate, including with respect to any and all purchases or orders for goods or services made from Impact Property Solutions related to such property or properties, (v) I (we) authorize any person having information related to the management company or the applicable owner(s) to release financial information as credit reports to Impact Property Solutions.
Date
*
-
Month
-
Day
Year
Date
Title
*
Signature
*
Printed Name
*
I (we) further agree and acknowledge: (i) that all invoices shall be payable to Impact Property Solutions at 730 W. Washington Street, Orlando, FL 32805, net 30 days of the invoice date, payable by check or ACH unless otherwise agreed in writing by Impact Property Solutions, (ii) to pay interest at the lesser of (a) 18% per annum or (b) the maximum interest rate permitted by applicable law on all invoices not paid within 30 days of the invoice date, (iii) I (we) shall defend, indemnify, reimburse, and hold harmless Impact Property Solutions from any and all losses, damages, fees, costs and expenses, including reasonable attorneys’ fees (including without limitation), fee costs and expenses related to collection of amounts outstanding or the enforcement of the terms hereof, including issuing demand letters and filing mechanics liens); (iv) performable in the terms of this account activation form or any matter arising hereunder or in connection with the goods and services contemplated hereby shall be Orange County, Florida, (v) account activation will not be complete until I (we) have signed and delivered this account activation form, and (vi) I (we) have the authority to act as agent on behalf of the owner(s) of the property or properties to which the goods and services contemplated hereunder relate, including to bind such owner(s) to the terms and conditions hereof in all respects.
Date
*
-
Month
-
Day
Year
Date
Title
*
Signature
*
Printed Name
*
Upload File
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Print Form
Submit
Should be Empty: