Please PRINT THIS PAGE sign and date this agreement and return it to WINDHAM EQUIPMENT RENTALS, INC.
WINDHAM EQUIPMENT RENTALS, INC.
5477 Route 23
PO Box 878
Windham, NY 12496
(518)734-3335
(518)734-3336 Fax
Date:___________
Name: ____________________________________ Phone: ______________
Address: __________________________________ How Long: ___________
Previous Address: ___________________________ How Long: ___________
Type of Account Desired: Personal_____________ Business _____________
If Business:
Individual:___________ Partnership:____________ Corporation:__________
Business Started: ___________
Principals: ______________________________________________________
Name and Title Address
Owner of Partners: _______________________________________________
Does company have a certified financial statement? Yes______ No________
If yes, please furnish with credit application
If Personal:
Employed by: ____________________________________________________
Name Address Phone
Income: $________________ Length of Employment: ________________
Previous Employer: ________________________________________________
Spouses Name: _______________ Single ____ No. of Dependents: ________
Other Income: _____________________ Own Home: ________ Rent: _______
Bank References:
________________________________________________________________
Name Address Type of Account
________________________________________________________________
Name Address Type of Account
________________________________________________________________
Name Address Type of Account
WINDHAM EQUIPMENT RENTALS, INC.
5477 Route 23
PO Box 878
Windham, NY 12496
(518)734-3335
(518)734-3336 Fax
Dear Customer:
In order to protect both Windham Equipment Rentals, Inc. and you from having unauthorized persons ordering and/or picking up materials under your name, please fill out this form with the names of those people who are authorized to transact under the name of your account. People other than those listed here may pick up materials only if Windham Equipment Rentals, Inc. has been notified in advance.
Print Name: Signature:
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
5. ___________________________________________________________
____________________________
(Authorized By)
____________________________
(Date)
* Please alert accounts receivable immediately if any authorization are added or removed.
Credit & Trade
Name Address Type of Account
Name Address Type of Account
Name Address Type of Account
Credit Terms
-Payment is due upon receipt of statement. A finance charge will be added at the rate of 2% per month (24% A.P.R.) on balances not paid within 30 days. All accounts 90 days past due will be subject to collection procedures. The privilege of open credit requires payment of charges, which are due upon presentation.
-Windham Equipment Rentals, Inc. reserves the right to SUSPEND CHARGING PRIVILEGES WITHOUT NOTICE if your invoice balance becomes “overdue” or your account exceeds its assigned credit limit.
-In the event that your account is sent to a collection agency or attorney, you agree to pay, in addition, all collection costs, including, but not limited to, court fees, sheriff’s fees, reasonable collection agency charges and reasonable attorney’s fees.
-You hereby permit Windham Equipment Rentals, Inc. (its agents or employees) to make drop deliveries at the delivery site designated in your order without first obtaining the signature of an authorized person. The occasion may arise that you are not on site to sign for said delivery. In such case you waive any defense that you may have in respect to loss or theft of delivered items, unless you can affirmatively prove non-delivery of merchandise was due solely to error, negligence, or theft on the part of Windham Equipment Rentals, Inc. agents or employees.
-I/We have read the above credit terms and fully understand them and do hereby personally guarantee payment in accordance with these terms.
-I/We authorize Windham Equipment Rentals, Inc. to make whatever credit inquiries it feels necessary in connection with this credit application.
Signature: _________________________ Spouse: ______________________
Social Security #: ___________________ Social Security#: ________________