Application For Credit - Timewell Drainage Products

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BUSINESS INFORMATION

Timewell Rep's Name

Account Name*

Street Address*

City*

State*

Zip*

Phone*

Email*

Fax

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Rep Email

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Employer ID Number (EIN)

Year Established

Please provide tax exemption number:

Tax Exempt Form

If tax exempt, please attach a copy of the form here

Max. file size: 10 MB.

What credit line are you requesting?

OWNERS, PARTNERS OR CORPORATE OFFICERS

First Name*

Last Name*

Home Address

Cell Phone

Email

First Name*

Last Name*

Home Address

Cell Phone

Email

BANK REFERENCES

Please contact your banks to approve releasing information

Name of Primary Bank*

Name of Contact

Address

Phone

Email Address

Fax Number

Name of Bank

Name of Contact

Address

Phone

Email Address

Fax Number

TRADE REFERENCES

Please list 3 credit references

Company Name*

Name of Contact

Address

Phone

Email Address

Fax Number

Company Name

Name of Contact

Address

Fax Number

Email Address

Phone

Company Name

Name of Contact

Address

Phone

Email Address

Fax Number

Document Upload

You may upload documentation and references here.

File(s)

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Accepted file types: jpg, pdf, Max. file size: 10 MB, Max. files: 4.

TERMS

ENTIRE AGREEMENT: This agreement is between Timewell Drainage Products ("Seller") and the applicant named above ("Applicant"). These terms and conditions along with the terms and conditions on Seller's invoices and delivery tickets, which are incorporated by reference (together referred to as "TERMS") represent the entire agreement between the parties. No other terms - including those on Applicant's Purchase Orders - which are different may add to, modify, supersede or otherwise alter the TERMS without express written approval signed by an authorized representative of the Seller. All other terms are hereby rejected.

PAYMENT: Timewell Drainage Products payment terms are Net 30 days. A 1% discount is applied to invoices paid within 10 days. Timewell reserves the right to charge interest at a rate of 2% per month (24% per annum) on all invoices that are past due. Timewell also reserves the right to charge Applicant for the cost of collection of any past due invoices, including but not limited to, attorney fees, court costs and collection agency fees in addition to late payment fees and amount due.

CERTIFICATION: The Applicant certifies the following: (1) the information I provided is true and correct and has been submitted to obtain commercial credit; (2) I am authorized to execute applications and other documents required to establish commercial credit accounts on behalf of Applicant; (3) Seller is hereby authorized to investigate and verify any information provided and inquire of references or others as to creditworthiness; (4) Seller may answer questions from others about its credit experience with the Applicant; and (5) I have read, understood, and agreed to all the TERMS, and agree to notify the Seller, in writing via certified mail, of any material change in name, ownership, location or corporate status within five (5) days.

Your Signature*

Typing your name acts as a digital signature and signifies that you understand and agree to the Terms above.

PERSONAL GUARANTEE

For and in consideration of the Seller extending credit to the Applicant and with the understanding that without this Guarantee Seller would not extend such credit, the undersigned Guarantor hereby personally guarantees the payment of any obligation of the Applicant to the Seller. Therefore, Guarantor hereby agrees to pay the Seller on demand, without offset, any sum due to the Seller by the Applicant if and when Applicant fails to pay such amount. Guarantor further agrees to pay all costs of collecting including but not limited to attorney fees, court costs and collection agency fees in addition to late payment fees and amount due. This Guarantee shall be a continuing and irrevocable guarantee for indebtedness of the Applicant. Furthermore, Guarantor consents to and waives notice of any modification, amendment or extension of the credit agreement hereby guaranteed.

Your Name

Typing your name acts as a digital signature and signifies that you understand and agree to the Guarantee above.