Manufacturers of Steel Bar Joists / Steel Deck and Accessory Supplier


Credit Application


PLEASE COMPLETE THE FOLLOWING FORM, THEN PRINT AND MAIL/FAX IT TO THE ADDRESS ABOVE.  YOU MAY ALSO SUBMIT THE FORM ON-LINE THEN MAIL/FAX A HARD COPY TO US FOR EARLY PROCESSING.

Date:

Company Name
Bill To Address
Ship To Address
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-MAIL

Is Your Business:    Individually Owned Partnership Corporation

Name(s) of Owner(s) and Title(s):

Name Title
Name Title
Name Title

Kind of Business:        Years in Business   

County:        Tax Exempt (if yes, enclose a tax exempt form):    Yes No

Accounts Payable Contact:

Name
Title

P.O. Required:    Yes No

Approximate Credit Line Desired:

$1,000-$5,000
$5,000-$10,000
$10,000-$20,000
Over $20,000 (financial statement required)

TRADE REFERENCES WITH WHOM YOU HAVE ESTABLISHED CREDIT

Trade Reference 1:

Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Trade Reference 2:

Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Trade Reference 3:

Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
 

BANK INFORMATION

Name Of Bank 
Address
Account Number
Line of Credit Number
Phone Number
Fax Number
Contact Person

Permission For Bank To Release Information:


_______________________________
Signature

Name of Company

Name of Persons Authorized to Charge on Account:

    As a duly authorized owner/officer of the previously stated corporation, I/we, the undersigned, warrant that the information herein given is correct and request that standard credit terms be extended by Structures of U.S.A., Inc. to our company based on this information.  I/we authorize Structures of U.S.A., Inc. to verify our credit background and further authorize our references to release information directly to Structures of U.S.A., Inc. for such verification.
    The following TERMS OF SALE are agreed to:  Terms are net 30 days with a monthly service charge of 1/5% assessed and due 30 days after billing date.  Purchases, which are delinquent, will result in the account being placed on COD or CIA status.  Authorization must be made for all returned merchandise at which time it will be subject to a 15% handling charge.  A returned check will result in a return check fee of $20.00 and the account being placed on COD or CIA: certified funds or cash only until the returned check(s) is/are cleared.  Your credit line may be revoked or otherwise changed if returned checks are experienced.
    Monthly statements are mailed for reconciliation purposes only.  If the account is not paid in full as agreed, applicant agrees to pay all costs and expenses of collection, including costs and expenses on appeal, if any.  These expenses shall include a reasonable attorney fee.  If the outstanding balance is equal to any amount less than $5000.00 the undersigned agrees that the attorney's fee shall be a liquidated sum of 20% of the outstanding balance.  Thereof, we herein wave all rights relating to venue and agree that any and all legal actions shall be brought in the county of Cambria, State of Pennsylvania.

(Owner or Corporate officer must sign.)

______________________________________
Signature


______________________________________
Title


______________________________________
Date


PERSONAL GUARANTY

The undersigned for and in consideration of the extension of credit by Structures of U.S.A., Inc. to:

______________________________________________________________________________________

Jointly and severally herby personally guarantee to Structures of U.S.A., Inc. the payment of an obligation of the borrower and I/we herby agree to bind myself/ourselves, my/our heirs, executors, administrators, successors and assigns to pay Structures of U.S.A., Inc. on demand any sum that becomes due to Structures of U.S.A., Inc by the borrower whenever the borrower shall fail to pay the same.  It is understood that this guaranty shall be continuing and irrevocable guaranty and indemnity for such indebtedness by the borrower.  I/We do hereby authorize the prothonotary or any attorney of any court to appear therein, to confess judgment therein against me/us and in favor of the holder of this guaranty for the amount named herein, with interest and costs of suit and with ten (10) percent added for attorney fees.

***If Married, Both Parties Must Sign Agreement***

 

Date Date
Signature
____________________
Signature
____________________

Name


Name

Social Security # Social Security #
Date of Birth Date of Birth
Address Address
City City
State State
Zip Zip
Home Phone # Home Phone #

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Copyright 1999 Structures of U.S.A., Inc.  All rights reserved.
Revised: April 05, 2000