Buyer/Applicant Legal Trade Name*
DBA
Dun & Bradstreet
Date
Shipping Address*
City*
State* Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC TN TX UT VT VA WA WV WI WY
Zip*
Phone*
Same as Shipping
Business Address
Business City
Business State Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC TN TX UT VT VA WA WV WI WY
Business Zip
Phone
Type of Account Select Corporation Partnership Proprietorship
Officers or Owners
If Branch, indicate Parent Company
Years in business
Accounts Payable Contact*
Accounts Payable email*
Bank Reference
Bank Officer
Bank Officer Phone
Name
Address 1
Address 2
City
State Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC TN TX UT VT VA WA WV WI WY
Zip
Fax
Reference information furnished by
Terms
Buyer/Applicant authorizes Metraflex Company and its representatives to inquire into Buyer’s/Applicant’s credit history and to contact Buyer’s/Applicant’s references given, in addition to any other person, corporation or other entity, for the purpose of determining the credit worthiness of the Buyer/Applicant.
As a requirement of extending the credit privilege to Buyer/Applicant and in consideration for any extension of credit, Buyer/Applicant agrees to abide and be bound by Metraflex’s “Terms & Condition of Sale” as shown at www.metraflex.com/terms and incorporated herein by reference, applicable to each and every transaction between Metraflex and the Buyer/Applicant regarding the Sales of Metraflex products. Buyer/Applicant further agrees to execute from time to time any and all documentation reasonable requested by Metraflex to satisfy Metraflex that its “Terms and Condition of Sale” shall be controlling.
All invoices are DUE IN NET 30 DAYS. Invoices NOT paid within 30 days are PAST DUE.
All invoices, which are not paid in NET 30 DAYS are subject to a Service Charge of 1-1/2% interest PER MONTH, commencing with the 31st day and continuing until the funds are received by Metraflex.
Should the customer be a corporation, the undersigned agrees that by execution hereof, he/she or they are authorized to commit the customer for payment of all indebtedness or liabilities incurred pursuant to this agreement, demand for payment and notice of indebtedness and default are expressly waived.
Should it become necessary for Metraflex to retain an attorney to make demand upon or collect any past due invoices or statements, the customer agrees to pay all recording fees and court cost, incurring by Metraflex through all appeals, and bankruptcy proceedings, if any. Metraflex and the customer agree Metraflex shall choose the venue of any action brought to collect past due invoices or statements, or enforce any provision of this agreement.
Name*
Accept terms Accept with exceptions
Indicate exceptions here
If your office is a branch or subsidiary, please list theParent Company or Home Office.
Parent company
Metraflex sales person