masthead

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
 
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 #: _ _ _ - _ _ -_ _ _ _