Credit Application Posted on March 15, 2021 by Kamen Company InformationCompany Name(Required) Company Contact(Required) First Last Phone(Required)FaxBilling Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Physical Address(Required) Same as Billing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Type of Business(Required) Year Established(Required) Tax ID # Tax Exempt ID If Tax Exempt please include completed certificate with this application.Tax Exempt CertificateAccepted file types: pdf, jpg, png, doc, docx, Max. file size: 20 MB.Business License # Dunn & Bradstreet # Business(Required) Corporation Partnership Sole Proprietorship Limited Liability Corp. Name of Owners/Partners or Officers(Required) Add RemoveBank ReferenceBank Name Bank Address Bank Contact Bank Contact Email Bank Contact PhoneBank FaxBusiness ReferencesName, Address, Phone, and EmailReference #1Reference #2Reference #3If above information is incomplete a delay in processing application may occur.Conditions of CreditI/We hereby apply for open account credit terms with Custom Ornamental Iron, Inc. It is understood that Custom Ornamental Iron’s credit terms are net thirty (30) days. I/We understand that, if invoices are past due, Custom Ornamental Iron may seek collection through legal means. If this be the case, I/We further understand and agree that all collection charges, legal fees, and interest 1 ½% per month (18% per annum ) incurred on such past due invoices will be our responsibility. I/We further authorize references listed above to release payment history and credit information to Custom Ornamental Iron, Inc. Authorized Signature(Required)Authorized Signature (Optional)The undersigned who is the owner, partner or corporate principal of applicant, hereby personally guarantees the payment when due, of all debt and obligations of applicant to Custom Ornamental Iron, Inc. now existing or hereafter arising. This is a continuing guaranty to remain in force for as long as applicant has any indebtedness to Custom Ornamental Iron.Personal Guarantor(Required)Personal Guarantor (Optional)
