CUSTOMER APPLICATION

Please download, print and fill out this application. Then, send it to michelle@totalairsupply.com or return it to your local branch or Territory Manager.

Fields marked with an * are required

BUSINESS INFORMATION

Select all that apply:
Invoices to be sent (check one) *

REFERENCES – BANK (checking account)


REFERENCES – TRADE

APPLICANT’S SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY AND ABILITY AND WILLINGNESS TO PAY OUR INVOICES IN ACCORDANCE WITH THE FOLLOWING TERMS:

1. Terms: 1% – 10th Net 30th. (A) 1% discount will be allowed on invoices if paid by the 10th of the following months. (B) Net 30th – Invoices MUST BE PAID by the 30th of the month following purchase.

2. There will be a 2% per month finance charge (25% per annum) on any outstanding amounts due over 30 days. This rate will continue to accrue during the pendency of any litigation or collection efforts until paid in full.

3. I (we) guarantee payment of any debts thus contracted.

4. The applicant hereby agrees to pay the cost of collection, including attorney’s fees and court costs, in the event such collection measures are necessary.

5. I (we) authorize my bank(s) stated above to provide information for credit purposes.

6. The terms of this Credit Application shall supersede any terms established on any purchase orders provided by you, the customer.

7. The above information is for the purpose of obtaining credit and is warranted to be true.

DATE *

PRINCIPAL(S):
Date of Birth *
Have You Ever Filed Bankruptcy? *
If Yes: Personal or Business?

CONTINUING GUARANTEE

(herein after referred to as Debtor Business) to extend credit to it and WHEREAS, the said TOTAL AIR SUPPLY LLC is willing to extend such credit only on the condition that the Guarantor will guarantee payment of any debts thus contracted by the said Debtor Business. WHEREAS, the undersigned Guarantor is a principal of Debtor Business.

NOW, THEREFORE, for value received, the Guarantor, jointly, severally and individually does hereby guarantee full payment of any debts that may be incurred in favor of TOTAL AIR SUPPLY LLC by Debtor Business now or any time in the future.

This Guarantee shall be construed as an absolute, continuing and unlimited guarantee of payment without regard to the regularity of any liability or obligation of said Debtor Business hereby guaranteed; and the said TOTAL AIR SUPPLY LLC shall not required to proceed first against the said Debtor Business or any other person, firm or corporation or against any collateral security held by him before resorting to the Guarantor for payment.

TOTAL AIR SUPPLY LLC. terms of sale are 1% – 10th Net 30th. Past due accounts will be subject to a finance charge of 2% per month (24% annually). Interest shall continue to accrue at the above stated rate during the pendency of any litigation or collection efforts until paid in full.

In the event of necessary legal action to collect outstanding and delinquent debts due TOTAL AIR SUPPLY LLC, I fully agree to assume and pay the full amount of the debt plus any and all reasonable legal fees and all collection fees.

This Guarantee shall supersede any terms established on any purchase orders provided by you, the Debtor Business. This Guarantee shall also apply to all outstanding obligations of the debtor incurred prior to the date indicated below.

Date *
Date *

CUSTOMER PROFILE

BUSINESS PROFILE
Estimated percentage of business: (Combined totals must = 100%)
Estimated percentage of business: (Combined totals must = 100%)
Are you EPA Certified? *
Are you Gas Licensed? *
Do you buy and install square commercial duct? *
Do you buy and install spiral pipe? *