Credit Form – Bleam Doors

Credit Application Form

Company Information

Business Name:

DBA (if applicable):

Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Business Details

Years in Business:

Federal Tax ID #:

Resale Certificate #:

Accounts Payable

Contact Name:

Phone Number:

Email Address:

Trade References
(Please provide at least three references)

1. Company Name:

Contact Name:

Phone Number:

Email Address:

2. Company Name:

Contact Name:

Phone Number:

Email Address:

3. Company Name:

Contact Name:

Email Address:

Phone Number:

Bank Reference

Bank Name:

Branch Location:

Phone Number:

Account Manager:

Account Number:

Authorization
The undersigned hereby authorizes Bleam Doors & Mouldings to make inquiries into the banking and business/trade references provided herein.

Authorized Signature:

Printed Name:

Title:

Date

Terms and Conditions
By signing this application, the applicant agrees that payment for all invoices is due within 30 days from the date of invoice unless otherwise agreed in writing. Late payments may be subject to a penalty of 1.5% of the entire contract. The applicant agrees to pay all reasonable attorney fees and costs of collection in case of default. Credit terms may be changed or revoked at any time without prior notice.

Credit Application Form

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Open the door. We’re waiting to deliver excellence.

© Bleam Doors, 2023