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BMSI CREDIT APPLICATION
____PARTNERSHIP
____SOLE OWNERSHIP ____CORPORATION
LEGAL BUSINESS NAME:
________________________________________________________________
Business
Address:_____________________________City:______________State:_______Zip:_________
Street Address:
_______________________________City:______________State:_______Zip:_________
Business Phone:______________
Fax:______________ In Business: ____Years _____Months
Federal Tax#:_________________ State
License#:________________ Mpls
License#:_______________
NAMES,
ADDRESSES & HOME PHONE NUMBERS OF OFFICERS, PARTNERS OR OWNERS:
Name:______________________Title:_________Home Phone:_____________SSN#:_________________
Street Address:
_________________________City:______________State:_______Zip:_______________
Drivers License#:________________________ State:_____________
BANKING
INFORMATION:
Name:________________________________Address:_________________________________________
Contact:_______________________ Phone:___________________
Fax:_______________________
Checking#:________________
Savings#:_______________ Loan#:________________
SUPPLIER
REFERENCES:
1. Name:___________________________
Address:____________________________________________
City:_______________State:________Zip:________ Phone:_______________Fax:___________________
2. Name:___________________________
Address:____________________________________________
City:_______________State:________Zip:________Phone:_____________Fax:______________
3. Name:___________________________
Address:____________________________________________
City:_______________State:________Zip:________Phone:_____________Fax:______________
 Sign
Back
The undersigned agrees
that, if credit is granted by Building Material Supply, Inc., the undersigned
will be responsible for all invoices as presented. I (we) certify that the
information furnished is true and correct. Building Material Supply, Inc. has
the right to investigate my (our) credit and income records, and has the
right to verify my credit references and to report my payment of this account
to credit bureaus and other interested parties.
______________________________________________ ________________
____________________
SIGNATURE TITLE
DATE
In consideration of
the granting of credit by Building Material Supply, Inc. to the person(s) or
companies to whom credit is extended pursuant to this application, the
undersigned, unconditionally, jointly and severally, guarantee(s) payment for
all purchases made by said person(s) or companies. In addition, the undersigned
guarantee(s) payment of any late fees and cost of collection including any attorneyâs fees. The undersigned waives notice of
acceptance of this guarantee and notice of any default and demand of every
kind, nature and description and waives notice of accrual of any obligation
or continuing guarantee and shall not be affected by any extension of time,
payment, modifications or additions. A corporate title after my/our signature
does not negate my/our personal guaranty. This is a continuing guaranty binding
the undersigned and their heirs, successors and legal representatives. It
shall continue in force until written notice of revocation is actually
received by Building Material Supply, Inc. No revocation of this guaranty
shall affect any obligations of Guarantor or customer then existing. Building
Material Supply, Inc. reserves the right to send out Notice to Owners and
file liens.
DATE:______________________
____________________________________________
______________________________________________
Individually & as an agent for applicant Print Name
____________________________________________ ______________________________________________
Individually & as an agent for applicant Print
Name
____________________________________________ ______________________________________________
Individually & as an agent for applicant Print
Name
Applicant understands and agrees to the following credit
terms. Balance is due NET 30 DAYS of invoice date. Service charge of 1-1/2%
will be charged on all past due accounts.
CREDIT DEPARTMENT ONLY
OPEN______________ COD
__________________
Approved
Credit Line:__________________ By
Whom:______________________
Comments:__________________________________________________________
Manager’s Signature:________________________
Date:______________________
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