Business/Contractor Credit Application - Duke Concrete Productswww.dukeconcrete.com/PDFS/BCR.pdf518-793-7743 ⢠Fax 793-0179 pickettbuildingmaterials...
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Main Office:
Pickett Building Materials
Oneonta Block Company
OBC Landscape Supply
Duke Concrete Products
6459 State Highway 23 Oneonta, NY 13820 607-432-8391 • Fax 433-6284
6459 State Highway 23 Oneonta, NY 13820 607-432-6641 • Fax 433-6284
65 State Route 369 Port Crane, NY 13833 607-369-7051 • Fax 369-7050
50 Duke Industrial Park Queensbury, NY 12804 518-793-7743 • Fax 793-0179
pickettbuildingmaterials.com
oneontablock.com
dukeconcrete.com
Business/Contractor Credit Application Name of Business _____________________________________________________________________ Mailing & Street Address ________________________________________________________________ City, State, Zip _________________________________County _________________________________ Phone Number Including Area Code ____________________ Fax _______________________________ Type of Business_______________________________________________________________________ How Long in Business at this Address? _____________________________________________________ Please Circle One:
1. Corporation
2. Incorporated
3. Partnership
Subsidiary/Division of ___________________________________________________________________
________________________________________________________________ Owners/Partners/Officers _____________________________________________________________________________________ Name Title SSN Drivers License _____________________________________________________________________________________ Name Title SSN Drivers License _____________________________________________________________________________________ Name Title SSN Drivers License
________________________________________________________________ Amount of Credit Requested on a Monthly Basis $_____________________________________________ Persons Authorized to Charge 1. _______________________________________
2._____________________________________
3. _______________________________________
4. _____________________________________
Do you require Purchase Orders? _________________________________________________________ ______________________________________ Federal ID#
____________________________________________ State Resale Certificate # (Attach Copy)
Main Office:
Pickett Building Materials
Oneonta Block Company
OBC Landscape Supply
Duke Concrete Products
6459 State Highway 23 Oneonta, NY 13820 607-432-8391 • Fax 433-6284
6459 State Highway 23 Oneonta, NY 13820 607-432-6641 • Fax 433-6284
65 State Route 369 Port Crane, NY 13833 607-369-7051 • Fax 369-7050
50 Duke Industrial Park Queensbury, NY 12804 518-793-7743 • Fax 793-0179
pickettbuildingmaterials.com
oneontablock.com
dukeconcrete.com
Bank References __________________________________________ Name of Bank
_____________________________________ Account Number
__________________________________________ Address
_____________________________________ Phone # Including Area Code
________________________________________________________________ Business References __________________________________________ Name & Address of Company
______________________________________ Phone #
___________________________________________ Name & Address of Company
_____________________________________ Phone #
___________________________________________ Name & Address of Company
_____________________________________ Phone #
________________________________________________________________ Terms 1. 2. 3. 4. 5.
Statements are due Net 10 days from Statement Date. Service Charges—A service charge of 2% per month on the unpaid balance of accounts 30 days past due and older. Accounts 60 days past due will not be allowed any further purchases until the balance due is settled. Pickett Building Materials, Duke Concrete Products and Oneonta Block Company reserve the right to limit the extent of any of the customers purchases. Pickett Building Materials, Duke Concrete Products and Oneonta Block Company may declare the unpaid balance to be due and payable if I default in making any required payment when due, and may charge a reasonable attorney’s fee and costs of collection if this account is referred to an attorney for collection.
Signatures
Date
Owners/Partners _______________________________________________
________________
_______________________________________________
________________
Spouse
_______________________________________________
________________
Corporation President
_______________________________________________
________________
Vice President
______________________________________________
________________
Main Office:
Pickett Building Materials
Oneonta Block Company
OBC Landscape Supply
Duke Concrete Products
6459 State Highway 23 Oneonta, NY 13820 607-432-8391 • Fax 433-6284
6459 State Highway 23 Oneonta, NY 13820 607-432-6641 • Fax 433-6284
65 State Route 369 Port Crane, NY 13833 607-369-7051 • Fax 369-7050
50 Duke Industrial Park Queensbury, NY 12804 518-793-7743 • Fax 793-0179
pickettbuildingmaterials.com
oneontablock.com
dukeconcrete.com
Business and Individual Guarantee I hereby authorize Arnan Development Corporation, dba Oneonta Block Company, dba Duke Concrete Products and dba Pickett Building Materials, its agents or any credit bureau or other investigative agency employed by such person, to investigate and reference herein listed or statements or other data obtained from me or from any other person pertaining to my credit and financial responsibility. I understand that accounts are to be settled in full in accordance with the terms extended by Arnan Development Corporation and that any balances are subject to a service charge of 2% per month (annual percentage rate 24%) We, jointly and individually, personally guarantee the indebtedness incurred by ______________________________________________________________________________________ for all purchases of material or other services, service charges, collection fees, legal fees, processing and filing costs in the collection of this account. It is understood that we are responsible for all indebtedness up to the date of a written notice of termination and allowing 10 days to clear all transactions in progress. ______________________________________________________________________________________ Name of Business or person(s) requesting Credit ______________________________________________________________________________________ Address ______________________________________________________________________________________ Business Federal ID # Individuals Please Sign Below ______________________________________________________________________________________ Date Signature SSN
______________________________________________________________________________________ Date Signature SSN
______________________________________________________________________________________ Date Signature SSN
Approved by: __________________________________________________________________________
