RPM Customer Credit Application
Return to: Onboarding@usequipsales.com
Date:
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Month
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Day
Year
Date
New Applicant Account
Credit Update
TO ENSURE PROMPT PROCESSING OF APPLICATION, PLEASE PRINT LEGIBLY OR TYPE
I.
Business Name
DBA if Applicable
Federal Tax ID#
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address (if different than above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name
Phone#
Format: (000) 000-0000.
Email:
example@example.com
Tax Exempt
YES
NO
(If yes, please include exemption certificate)
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of
Length of time in business
Credit Application
(If you do not wish to apply for credit, do not fill out the next section)
II. Type of Business (Please check one)
Type of Business
Corporation
Partnership
Government
Sole Proprieter
LLC
Other
III. Billing Information Preferred
Job Name or Number
Monthly Statements
YES
NO
Purchase Order
A/P Email
example@example.com
IV. Applicant Information - Owner, Officer, Partner Contact Information
Name
First Name
Last Name
Title
SSN
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
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Insurance Company:
Name & Address
Phone #
Format: (000) 000-0000.
Fax #
Note: If you plan to utilize our rental services and do not wish to pay a physical damage waiver charge, please have your insurance company forward a Certificate of Insurance covering rented or leased equipment with our company as "Certificate Holder" and named as loss payee or additional insured.
V. Banking Information
Bank Name
Contact Name
Phone
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Account Type
Checking
Savings
Bank Account #
Routing #
VI. Trade References
Business Name
Contact Name
Email
example@example.com
Business Name
Contact Name
Email
example@example.com
Business Name
Contact Name
Email
example@example.com
VII. Contract Terms and Conditions
Applicant hereby applies to U.S. Equipment Rentalsand Sales, LP ("US Equipment") for credit and specifically consents to investigating Applicant's credit history and authorizes the release of its bank account information. If credit is extended, Applicant acknowledges that U.S. Equipment requires payment upon receipt of invoice. Invoices are considered past due at 31 days. In the event of failure to timely pay any invoice, Applicant agrees to pay a service charge to U.S. Equipment on such delinquent invoice(s) until fully paid, at the maximum rate allowed by the laws and jurisdiction of the originating location stated on the invoice, and collection costs and/or attorney's fees in an amount that is not less than 25% of the outstanding balance owed. At the discretion of U.S. Equipment, any account with a delinquent balance may be placed on a cash basis at any time, and the equipment picked up without notice. Additionally, U.S. Equipment reserves the right to pursue remedies available. it under the party's contracts at law or equity. Applicant agrees to be bound by the terms and conditions as set forth in U.S. Equipment's standard form ofRental and Sales Agreement, or similar document, in use at the time of each rental or sales transaction in the jurisdiction where the purchase or rental occurs, which terms and conditions are incorporated herein by reference and which constitute a part of the credit agreement, regardless of whether not the agreement is executed by authorized representative of Applicant U.S. Equipment reserves the right to file preliminary notices for work done in states where these notices are required by state law in order to protect our lien rights.
Application Signature
Date
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Month
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Day
Year
Date
Title
Print Name of Applicant
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VIII. Personal Guaranty
The undersigned guarantor(s), for and in consideration of U.S. Equipment extending creditatmy/our request to the Applicant named above, in which I/we have a financial interest, jointly, severally and unconditionally personally guarantee prompt payment and performance of any obligations of Applicant to U.S. Equipment whether now existing or hereinafter made, and further agree to bind myself/ourselves to pay on demand any sum which is due by Applicant to U.S. Equipment whenever Applicant fails to pay the same. It is understood that this guaranty shall be absolute, continuingand irrevocable for such indebtedness of Applicant I/We expressly waive presentment, demand, protest, my/our home ste ad exemption as to this debt, notice of protest, dishonor, diligence, maturity, default or nonpayment, acceptance of this guaranty, extending of any guaranteed indebtedness already or hereafter contracted for by Applicant, any modifications or renewals of any credit agreement evidencing the indebtedness hereby guaranteed and all setoffs and counterclaims. If collection of amounts due requires the assistance of a collection agency or attorneys, suit is brought heron, or it is enforced through any judicial proceeding whatsoever, I/We agree (a) that U.S. Equipment reserves the right to bring legal action in whatever jurisdiction U.S. Equipment deems necessary, whose laws, at the option of U.S. Equipment, shall govern this Agreement, and (b) to pay all costs andexpenses of collection, including reasonable attorney's fees not exceeding a sumequal to twenty five (25%) of the outstanding balance owing, plus all other reasonable expenses incurred by U.S. Equipment in exercising any of U.S. Equipment's rights and remedies. The Undersigned recognizes the obligation of the Applicant and the undersigned agrees to hold the portion of all payments received by Applicant which include payment to Applicant for the rentand/or purchase of equipment and supplies fumished by U.S. Equipment pursuant to this agreement to be held in a separate trust account for payment to U.S. Equipment. The undersigned agrees to act as fiduciary for payment to U.S. Equipment and agrees that Applicant shall not use said payments for any other purpose, in exchange for the Applicant's ability to rent and/or purchase equipment and supplies on a credit account. The undersigned agrees that any failure to hold payments in trust for U.S. Equipment shall create a debt which is not dischargeable in bankruptcy and which shall be an exception to discharge pursuant to the terms of 11 USC 523(a)(4) and (6). The undersigned represent that (i) the information contained in the Agreement is a true and correct statement of the financial condition of the Applicant; and (ii) a photo copy or facsimile copy of this Agreement shall be valid as the original. If any part of this Agreement is heldunenforceable, the remainder of this Agreement shall not be affected thereby. The undersigned herby waives the right to a jury trial of any or all claims or disputes which may arise from this Agreement. U.S. Equipment shall not be required to exhaust all remedies against Applicant prior to exercising its rights against Guarantor(s). I/We authorize U.S. Equipment to make whatever credit inquiries it deems necessary in connection with this Agreement. Bank and trade reference(s) can accept this authorization to disclose to U.S. Equipment and/or their respective de signees (and any assignee or potential assignee thereof), Guarantor(s) information normally released to a prospective creditor including: length of time account has been active, average monthly balances, how the account has been handled, and details of any lending relationship.
Guarantor's Signature
Print
Date
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Month
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Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guarantor's Signature
Print
Date
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Month
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Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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