Application For Credit -

Billable accounts are available to our customers falling under certain classifications, accredited educational institutions, corporations, government agencies, publicly traded companies and public schools. Credit can be applied for by completing this application.

ORGANIZATION ACCOUNT INFORMATION - Organization Name: *

If Division/ Subsidiary, Name of Parent Co.

Registered Company Street Address: City: State: Zip: *

Phone Number *

Date Organization Founded: *

Tax ID # *

Is Organization Tax Exempt? *

(If you organization is tax exempt, please email a copy of your exemption form to service@atlantaequipment.com)

ORGANIZATION TYPE *

Corporation
Partnership
Sole Proprietorship
Governmental

PRINCIPLE OWNERS/ PARTNERS/ OFFICERS Names and Titles *

ACCOUNTS PAYABLE CONTACT INFORMATION - Contact Name *

Accounts Payable - Contact Phone Number *

Accounts Payable - Contact Email *

Email for Invoices: *

Purchase Order required for payment of invoices? *

PERCHASING CONTACT INFORMATION - Purchasing Contact Name *

Purchasing Contact Phone Number *

Purchasing Contact Email *

: :

AUTHORIZED USERS (Organizational staff authorized to place requests) *

List All Names, Contact Phone Numbers, Contact Emails

SERVICE LOCATION INFORMATION - Service Location *

Street Address City State Zip *

Name of Preferred Contact on Site: Contact Phone Number: (if different from registered company address.) *

If your organization has multiple service locations, please email location list to service@atlantaequipement.com for upload to your account.

FINANCIAL INFORMATION: Bank Name: Bank Street Address: City State Zip Code *

Bank Account Number: Bank Contact Name: Bank Phone Number: Dunn and Bradstreet Number if applicable: *

First Trade Reference: Name - Account Number- Street Address City State Zip - Phone Number - Email address *

Second Trade Reference: Name - Account Number- Street Address City State Zip - Phone Number - Email address *

Third Trade Reference: Name - Account Number - Street Address City State Zip - Phone Number - Email address *

Atlanta Equipment Company extends credit to government agencies, educational institutions and corporations with a good, published credit rating. Companies may apply for an open account by supplying credit information on their company’s letterhead to Atlanta Equipment Company, or by completing this form. Credit information supplied by the buyer, or by others on the customer’s behalf, shall become part of the Credit Application, and any false or misleading information shall constitute fraud. Completing an application does not guarantee terms will be extended. Approved terms are Net 30 days, upon approval. Invoices on Net 30 payment terms shall be paid by company check, wiring funds, bank to bank (ACH) or credit card. Resale/Sales Tax - Credit Applications for companies located in the state of Georgia, USA, which are intended for resale, must be accompanied with a valid Resale Certificate. All Georgia companies with Tax-Exempt status must include the applicable documentation by emailing to service@atlantaequipment.com. Account Management and Remedies: In the event it becomes necessary for Atlanta Equipment Company to file suit to enforce payment of past due invoices, such a suit will be brought in Gwinnett County, Georgia, USA. Atlanta Equipment Company shall be entitled to collection of fees, court costs, and interest at 10% per annum or such legal maximum rate as is allowed, on all invoice amounts past due. Atlanta Equipment reserves the right to cancel terms at any time. By signing below Applicant warrants that (i) he or she is a duly authorized representative of the Applicant with full legal authority to bind the same by the execution of this Application and (ii) the information provided to Seller in this Application and any other provided financial statements are accurate, truthful, current and complete, and that such information is provided for the purpose of inducing Seller to extend credit to Applicant for the purchase of products, and/or services. Seller reserves the right to decline credit to any Applicant. Applicant authorizes Seller (and its authorized representatives) to (i) obtain and monitor credit information regarding Applicant's business from any source, including but not limited to, all references and banks listed in this Application and any credit reporting and granting institutions, and (iirelease information to credit reporting and granting institutions regarding Seller's credit experience with Applicant. Any references to a granted amount of credit in this Application will not be deemed a limitation of Applicant’s liability. *

Initial Here that you have read the above ststement.

Sign Here. Application to be signed by organization Authorized Representative *

Date: Job Title Phone Number: Email address: *

Atlanta Equipment Company

We are your experts in commercial kitchen equipment service and repair.

SERVING METRO ATLANTA AND NORTH GA

Application For Credit

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