MPI Sales Rep
Credit Amount Requested ($ Amount) *
Date *
Company Name *
Business Type *
Street Address *
City *
State / Province / Region *
Postal / Zip Code *
Phone Number *
Cell Phone Number
Fax
Shipping Address
Shipping Address Line 2
City
State / Province / Region
Postal / Zip Code
Please Send Invoices by:Please Choose:E-MailFax
Accts. Payable Email *
Purchasing Dept. Email *
Credit Requested By *
Home Street Address *
Home Address Line 2
Home Phone *
Cell Phone
In Business Since *
At This Address Since *
Business StructureChoose One:CorporationPartnershipSole Proprietor
Name
Title
Address 1
Address 2
Sales Tax Permit #
-- OR -- Fed. Tax ID #
Bank Name *
Branch *
Account # *
(minimum of three references required)
1. Name
E-mail
Phone
2. Name
E-Mail
3. Name
1. Notify Metal Panels Inc. of any changes in ownership of our company.
2. If granted credit, our company agrees to pay all invoices within the terms assigned to us.
3. It is agreed that our company will pay 1.5% per month, which is 18% yearly, for all past due invoices.
4. It is agreed that our account will become COD if we fail to pay invoices within terms.
5. Our company’s financial condition is satisfactory and we can meet financial obligations.
6. There are no lawsuits or judgments against me at the present time. If our company defaults on payment of any outstanding, valid invoices, we agree to pay attorney’s fees and/or collection expenses.
We hereby jointly and severally agree to guarantee payments for all accounts due Metal Panels Inc. from above named corporation, partnership or proprietorship within 30 days from date notice is given. In the event payment is not made and this account is turned over to an attorney, we also agree to pay reasonable attorney fees charged for collection.
Signature (Type Name) *
(The above typed name serves as a binding signature for this agreement.)
2 + 2 = ?Please prove that you are human by solving the equation *
