Atlas Wholesale Food New Customer Application & Agreement
Please fill out this application form to become an Atlas customer.
Your application will be reviewed by the Atlas team and you will be informed when an account has been created for you.
Customer Details:
Business Name
*
Name of Business (DBA)
Corporation Name and / or Legal Enttiy
Legal Entity Type:
*
Corporation
Partnership
Proprietorship
LLC
Business Type - Please select one:
*
Please Select
Broker
Casino
Family-style restaurant
Fast casual restaurant
Government
Headstart
Healthcare
Jobber
Manufacturing / Industrial
Military / Institutional
Restaurant / Bar / Tavern
School / College / University
Senior Living
Nonprofit
Religious organization
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is Billing Address the same as Shipping Address?
Yes
No
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Purchasing Contact Person
*
First Name
Last Name
Store Phone Number
*
Format: (000) 000-0000.
Cell Phone Number
*
Format: (000) 000-0000.
Purchasing Contact E-mail
*
example@example.com - this is where delivery confirmations will be sent
Billing Contact Person
*
First Name
Last Name
Billing Contact E-mail
*
example@example.com - this is where billing statements will be sent
Special instructions
ACCOUNT INFORMATION
Let us get to know your needs!
Estimated weekly delivery amount (in dollars):
*
Must be numeric
Earliest time accepting deliveries
Latest time accepting deliveries
Days and hours of operation
How did you hear about Atlas?
*
CREDIT APPLICATION
All new customers will be asked to pay the driver cash upon delivery for the amount of the invoice. After the first few deliveries, Atlas will reach out and collaborate to confirm the move from cash to 7-day ACH payment terms.
Business Tax ID / EIN
*
Owner Name
*
First Name
Last Name
Owner Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner Date of Birth
*
-
Month
-
Day
Year
Date
Owner Social Security Number
*
Owner Drivers License Number
*
Trade References - At least 3 are required
ACH Information
All new Atlas customers are put on 7-day ACH payment terms.
Bank name
*
Routing Number
*
Bank Account Number
*
What type of an account is this?
*
Checking
Savings
Which day of the week would you prefer your ACH payments to be pulled?
*
Monday
Wednesday
Friday
Attach a voided check image
*
Browse Files
Drag and drop files here
Choose a file
Please attach an image of a voided check
Cancel
of
Upload a copy of the Owner's Driver's License
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Terms & Conditions
Atlas Customer Credits and Return Policy
Please confirm understanding of Credits and Return policy
*
I have reviewed, and understand, the credits and return policy for Atlas Wholesale food
ACH DEBIT AUTHORIZATION
I (we)hereby authorize Atlas Wholesale Food Company (“Atlas”), to initiate debit entries to my (our) account indicated on this application at the depository financial institution indicated on this application (“Depository”), and to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of US law. The authorization is to remain in full force and effect until Atlas has received written notification from me (or either of us) of its termination in such time and in such manner as to afford Atlas and Depository a reasonable opportunity to act on it. ACCOUNT HOLDERS NOTE: If the account is in two names, both account holders must sign the authorization form. By signing this authorization, you warrant that you have the authority to do so and that no other signer is required other than those who have signed the form and agree to inform Atlas in advance of any changes that require this authorization or revocation of this authorization.
APPLICATION CERTIFICATION AND INDIVIDUAL / JOINT PERSONAL GUARANTY
For the purpose of obtaining an account with Atlas Wholesale Food, I (we) state the above Information is true and correct. The parties hereby agree that all purchases are subject to the following terms and conditions: COD payments are to be provided to the driver upon delivery. ACH payments will be pulled by Atlas from Customer per the agreed terms. All other payments with terms are to be sent to: Atlas Wholesale Food Co, 35500 Central City Parkway, Westland MI 48185, in accordance with the Credit Terms that are granted. I(We) agree to pay 1.5% per month, annual percentage rate of 18%, Time – Price Differential Charge on my amount past due. I (We) understand that Credit Cards will be billed 3.5% processing fee, plus $50 per failed Credit Card transaction. I(We) understand returned checks and failed ACH payments will result in a $100.00 assessment which must be paid immediately. Atlas Wholesale Food shall have the right to demand payment of the return check(s) or failed ACH in CASH or CERTIFIED funds or MONEY ORDER within forty-eight (48) hours. Atlas reserves the right to hold deliveries for any customer who has past due amounts. It is further agreed that the undersigned will pay all collection agency fees and reasonable attorney fees that may become necessary to effect collection of this account. All new accounts will be shipped C.O.D. until credit is approved by the credit office. Customer’s credit worthiness and terms are subject to change at any time at Atlas’s sole discretion. The parties hereto agree and consent to venue in Wayne County, 36thJudicial District Court in Detroit, Michigan for any lawsuit to be filed to enforce the obligation in this agreement. In order to induce Atlas Wholesale Food Co to extend and open credit to the above listed company, of which I have direct financial interest and/or for which I am an officer or agent, I do hereby guarantee payment to you of all indebtedness of any sum due from the company if it fails to pay upon demand. I do hereby waive notice of default, non-payment and notice thereof and consent to any modification or renewal of the credit agreement. If any balance is turned over to a collection agency or an attorney for collection, I(we) agree to pay actual reasonable attorney fees, normally estimated to be 40%of the balance due plus interest, which is standard in the industry, plus all other collection costs.
Guarantor #1 Name
*
First Name
Last Name
Guarantor #1 Signature
*
Guarantor #2 Name
First Name
Last Name
Guarantor #2 Signature
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