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Business Contact Information

Company Name *

Phone *

AP Contact Email *

Street Address *

City, State, and Zip Code *

Date Business Commenced *

*

Payment Method * :

SHIPPING INSTRUCTIONS

Street Address *

City, State, and Zip Code *

Contact and Phone *

Any shipping notes or restrictions? *

Shipping Contact Email *

BUSINESS/TRADE REFERENCES

Company Name *

Street Address *

City, State, and Zip Code *

Phone *

Email *

Length of Relationship *

Average Monthly Account Balance *

Company Name

Street Address

City, State, and Zip Code

Phone

Email

Length of Relationship

Average Monthly Account Balance

Company Name

Street Address

City, State, and Zip Code

Phone

Email

Length of Relationship

Average Monthly Account Balance

AGREEMENT

  • All invoices are to be paid in accordance with quoted terms and listed on the invoice. Past due invoices will be subject to a 1-1/12% per month service charge. In the event of default and if the account is placed with an attorney or bonded collection agency, we further agree to pay a 30% collection charge.

  • Claims arising from invoices must be made within five working days.

  • By submitting this application, you authorize Flexcraft Company to make inquiries into the banking and business/trade references that you have supplied.

SIGNATURE

Name *

Title *

Date *