Ambient Edge LLC Business Credit Application

Ambient Edge LLC Business Credit Application

Account Set Up and Payment Terms
Company Name
Phone Number
Please enter a valid phone number.
Main Contact
Name
Email
example@example.com
Service Location

Street address

Street Address Line 2

CityState

Postal / Zip Code
ZIP Code
Unit or Suite Number
Date business commenced

MonthDayYear
Date
BUSINESS AND CREDIT INFORMATION
Primary business address, if different than service location.
Unit
ZIP Code
Accounts Payable Contact Name
Accounts Payable Email
example@example.com
Accounts Payable Telephone
Business or Trade References/Referrals

List businesses who you have worked with or refer customers to.
Company Name #1
Phone
Service Location

Street address

Street Address Line 2

CityState

Postal / Zip Code
Email
example@example.com
Company Name #2
Phone
Service Location

Street address

Street Address Line 2

CityState

Postal / Zip Code
Email
example@example.com
Company Name #3
Phone
Service Location

Street address

Street Address Line 2

CityState

Postal / Zip Code
Email
example@example.com
1. All invoices are to be paid 30 days from the date of the invoice. 2. Claims arising from invoices must be made within seven working days. 3. By submitting this application, you authorize Ambient Edge Air Conditioning and Refrigeration, Inc. to make inquiries into the banking and business/trade references that you have supplied.
Signature

Clear
Signature

Clear
Print Name
Title
Print Name
Title
Date

MonthDayYear
Date
Date

MonthDayYear
Date
Contact Us

Corporate Office Ambient Edge, LLC 3270 Kino Ave, Kingman AZ 86409 928.718.1017 newcustomerintake@ambientedge.com www.ambientedge.comAZ ROC 333029/ NV LIC# 0088094
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Ambient Edge LLC Business Credit Application

BUSINESS AND CREDIT INFORMATION

Business or Trade References/Referrals

Contact Us