Net 30 Terms Account Application

Net 30 Terms Account Application

Complete this application to open a Net 30 open-account with B&C Industrial Products. Approval typically takes 2 to 3 business days. Questions? Call us or email sales@bandcip.com.
Section 1 - Company Information
Legal Company Name
DBA / Trade Name
Years in Business
Type of Business Entity
Federal Tax ID / EIN
Company Phone
Please enter a valid phone number.Format: (000) 000-0000.
Company Website
Nature of Business / Industry
Section 2 - Billing Address
Billing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Section 3 - Shipping Address
Shipping address is the same as billing address
Shipping Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Section 4 - Accounts Payable Contact
AP Contact Name

First NameMiddle NameLast Name
AP Title
AP Phone
Please enter a valid phone number.Format: (000) 000-0000.
AP Email
example@example.com
Preferred Invoice Delivery Method
Purchase Order Required on all orders?
Section 5 - Purchasing Contact
Purchasing Contact Name

First NameMiddle NameLast Name
Purchasing Phone
Please enter a valid phone number.Format: (000) 000-0000.
Purchasing Email
example@example.com
Section 6 - Tax Exemption
Are you tax exempt or purchasing for resale?
State(s) of Exemption
Upload Resale Certificate or Tax Exemption Certificate

Cancelof
Section 7 - Bank Reference
Bank Name
Bank Branch / City and State
Account Officer / Contact Name

First NameMiddle NameLast Name
Bank Phone
Please enter a valid phone number.Format: (000) 000-0000.
Account Number
Section 8 - Trade References

Please provide three suppliers you currently buy from on open account.
Reference 1 - Company Name
Reference 1 - Contact Name
Reference 1 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 - Email
example@example.com
Reference 1 - Your Account Number
Reference 2 - Company Name
Reference 2 - Contact Name
Reference 2 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 - Email
example@example.com
Reference 2 - Your Account Number
Reference 3 - Company Name
Reference 3 - Contact Name
Reference 3 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 - Email
example@example.com
Reference 3 - Your Account Number
Section 9 - Terms and Agreement
Payment terms are Net 30 days from date of invoice. A 1.5% per month service charge (18% APR) may be applied to all past-due balances. The applicant authorizes B&C Industrial Products to obtain and verify credit information from the references listed above and from credit reporting agencies. B&C Industrial Products reserves the right to modify or revoke credit terms at any time. In the event of default, the applicant agrees to pay all costs of collection, including reasonable attorney fees. The undersigned certifies that all information provided in this application is true and complete.
I have read and agree to the Net 30 payment terms stated above and certify that all information provided is accurate.
Authorized Signature
Printed Name of Signer
Title of Signer
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Net 30 Terms Account Application

Section 1 - Company Information

Section 2 - Billing Address

Section 3 - Shipping Address

Section 4 - Accounts Payable Contact

Section 5 - Purchasing Contact

Section 6 - Tax Exemption

Section 7 - Bank Reference

Section 8 - Trade References

Section 9 - Terms and Agreement