Thompson Rental Credit Application

6009 Tower Avenue.  Superior WI 54880. Phone 715.392.5202.  Fax 715.395.5273

 

Thank you for filling this out completely.

 

Your name:                                                                                                                                                                  

Company/Corporate Names:                                                                   Date:                                                               

Street Address:                                                                                                                                                            

Mailing Address:                                                                                                                                                           

Phone Number:                                                                                      Fax number:                                                     

Accounts Payable Contact:                                                                    Estimate of monthly purchases from us:             

Type of Business:  r Sole Proprietor    r Partnership    r Corporation

 

 

Owners and/or Officers of Business

 

1.  Name:                                                                                  Position:                                                                      

     Address:                                                                                                                                                                 

2.  Name:                                                                                  Position:                                                                      

     Address:                                                                                                                                                                 

3.  Name:                                                                                  Position:                                                                      

     Address:                                                                                                                                                                 

 

 

Bank Reference

 

Bank name:                                                                                           Your account # :                                               

Bank address:                                                                                       Bank phone# :                                                  

 

 

Business References (where credit is now extended)

 

1.  Business Name:                                                       Phone:                                      Fax:                                         

     Address:                                                                                                                                                                 

2.  Business Name:                                                       Phone:                                      Fax:                                         

     Address:                                                                                                                                                                 

3.  Business Name:                                                       Phone:                                      Fax:                                         

     Address:                                                                                                                                                                 

Federal Tax Identification Number:                                                                                                                                  

r Taxable    r Variable by Purchase Order    r Exempt (Please attach or send a copy of your exemption certificate)

 

 

In consideration of Thompson Rental, Inc., extending credit to Applicant, Applicant agrees to pay for all items delivered to or at the request of Applicant by Thompson Rental, Inc. in accordance with our terms.  Applicant aggress that each of the terms and conditions of sale stated on the Thompson Rental, Inc. invoices shall be a term of the contract of each sale from Thompson Rental, Inc. to Applicant.  Applicant acknowledges that a monthly service charge of 1.5% shall be made on all sums due to Thompson Rental, Inc. which have not been paid by the 30th day of the month following billing, and Applicant agrees to promptly pay said service charge.  An additional service charge, computed on the same basis, will be due every 30 days thereafter.  Waiver of any one or more of these service charges shall not be deemed to be a waiver of future service charges.  Applicant further aggress that with regard to such service charge, Applicant and Thompson Rental, Inc. collection costs and attorney fees in addition to all other sums due.  The undersigned warrants that the above agreement has been carefully read and that Applicant understands the same.  Applicant represents and warrants said information is true and correct.

Applicant authorizes Thompson Rental, Inc. to obtain credit and financial information concerning the Applicant at any time from any source.

 

Name of Applicant:                                                                                                         Date:                                       

Signature:                                                                                                                     Title: