Credit and Company Application Form

PUREEANDDREAMS.COM
8400 Nw, 33rd Ste, suite 310.
Doral, Fl, 33122
Puree and Dreams, LLC
Accounting Department
management@pureeanddreams.com
Credit Aplication Agreement
Bussines information
Legal Company Name*
DBA NAme (Doing business As)
Main Contact*
Title
Email*
example@example.com
Phone*
Format: (000) 000-0000.
DUMS #
TAX ID #
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Entity (Corp. LLC, Inc.)
Year Established
State of Incorporation
Has your company field for Bancrupcy?
PLEASE REMENBER TO FORWARD A COPY OF W9 FORM (US CUSTOMERS) OR COPY OF WBEN (CANADA CUSTOMERS)
By submitting this credit application, the applicant authorizes Puree and Dreams LLC to verify all information provided, including trade and bank references, and to obtain credit reports as necessary for the purpose of establishing or reviewing credit. The applicant acknowledges that all invoices are due and payable within the terms stated on each invoice. A 20% monthly interest charge will be applied to all past due balances. Accounts more than 30 days past due may result in suspension or termination of credit privileges and/or future deliveries until the account is current. The a The applicant agrees to pay all costs incurred in the collection of delinquent accounts, including reasonable attorney and collection fees. Puree and Dreams LLC reserves the right to modify, suspend, or withdraw credit terms at any time without prior notice. All sales are subject to the company's standard terms and conditions of sale, including product handling and return policies specific to perishable food and beverage items. The undersigned certifies that all information provided is true and correct and agrees to the terms and conditions stated above.

Puree and Dreams, LLC
Accounting Department
Credit Aplication Agreement
Products & Services
Please describe your Business Model (Restaurant, Hotel, Distributor, Bar, Retail Store)
Product needed and Quoted
Main Contacs
Buyer Contact
Phone
Format: (000) 000-0000.
Mobile
Format: (000) 000-0000.
Email
example@example.com
Payables Contact
Phone
Format: (000) 000-0000.
Mobile
Format: (000) 000-0000.
Email
example@example.com
Email to send invoices*
example@example.com
Trade & Bank References
1) Comapny
Contact Name
Phone
Format: (000) 000-0000.
Address
Email
example@example.com
2) Comapny
Contact Name
Phone
Format: (000) 000-0000.
Address
Email
example@example.com
3) Comapny
Contact Name
Phone
Format: (000) 000-0000.
Address
Email
example@example.com

PUREE AND DREAMS LLC

We craft it, you enjoy it.
I HERBY DECLARE THAT THE INFORMATION FURNISHED ABOVE IS TRUE, COMPLETE AND CORRECT.
Full Name*
Title*
Signature*
Date signed*

MonthDayYear
Date
By submitting this credit application, the applicant authorizes Puree and Dreams LLC to verify all information provided, including trade and bank references, and to obtain credit reports as necessary for the purpose of establishing or reviewing credit. The applicant acknowledges that all invoices are due and payable within the terms stated on each invoice. A 20% monthly interest charge will be applied to all past due balances. Accounts more than 30 days past due may result in suspension or termination of credit privileges and/or future deliveries until the account is current. The applicant agrees to pay all costs incurred in the collection of delinquent accounts, including reasonable attorney and collection fees. Puree and Dreams LLC reserves the right to modify, suspend, or withdraw credit terms at any time without prior notice. All sales are subject to the company's standard terms and conditions of sale, including product handling and return policies specific to perishable food and beverage items. The undersigned certifies that all information provided is true and correct and agrees to the terms and conditions stated above.
Should be Empty:

Bussines information

Products & Services

Main Contacs

Trade & Bank References

PUREE AND DREAMS LLC