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BUSINESS INFORMATION

Business Name:

Application Submitted By:

Business Address:

City:

State:

Zip:

Business Phone:

Business Email Address:

Billing Address:

City:

State:

Zip:

Billing Phone:

Billing Email Address:

Billing Contact Name:

Type of Ownership:

{state of corp:  }

Federal Tax ID # (FEIN):

Contractor’s License #:

OWNER or OFFICER LIST
Name Title Driver’s License # SSN
1.
2.
3.
ACCOUNT REQUIREMENTS

Credit Limit Requested:$

Purchase Order required?:

Job Name Required?:

Job Number Required?:

Resale Number {Please forward resale form if applic.}:

TERMS AND CONDITIONS:

It is agreed that this application may be referred to any credit information service for approval; if credit is extended, it is further agreed that such extension of credit shall be subject to the following terms and conditions:

  1. I agree to meet BS&E Co. Inc. terms, which are 1% 10th prox., net 30th. The amount or amounts due, as evidenced by the account, shall be paid not later than the end of the following month from the invoice date.

  2. Any amounts not paid within the time allowed in item 1, above, shall be considered delinquent and shall bear a service charge of 1-1/2% per month or 18% per year to all amounts which are 60 days or more past due.

  3. If a delinquent account is placed in the hands of a licensed collector or an attorney for collection, or a suit is instituted on this account, there shall be paid a reasonable collection and attorney fee to the prevailing party.

  4. The undersigned agrees to provide BS&E Co. Inc. with all information relating to possible Mechanics Lien Claims as requested by BS&E Co. Inc.

  5. It is agreed the proper jurisdiction for any court action or arbitration hearing will be in Kern County, California.

  6. The buyer is responsible for ALL persons purchasing on their account, unless the buyer submits to the seller a list of persons authorized to purchase.

  7. The use of the customer’s purchase order number or job number on the Rental Agreement is for the customer’s convenience and identification only. The Rental Agreement prevails over any conflicting or additional terms of any PO, quote, order, acknowledgment or similar communication.

  8. The Equipment Protection Plan (EPP) is required unless Rentee has previously supplied the renter with a certificate of insurance for not less than $500,000.00 showing that protection is provided to B.S. & E. Co. Inc. for any damage to the rented item regardless of fault. Rentee understands EPP is not insurance. EPP is charged at 10% of the total rental fee.

TO BE SIGNED BY OWNERS / OFFICERS ONLY

Signature:

Title:

Date:

Signature:

Title:

Date:

Signature:

Title:

Date:

  By checking this box and typing your name above, I certify that the information provided in this Business Credit Application is accurate and complete to the best of my knowledge. I authorize BS&E Co. Inc. to verify the information and obtain credit details from relevant sources. I understand that credit approval is subject to BS&E Co. Inc.'s evaluation and agree to abide by the credit terms and conditions listed on this form.

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