Sanders Supply Credit Application

Fill out the form below to submit your application:

Business Name:

Date:

Business Segments (Check all that apply):
HVAC Plumbing Electrical Builder Distributor Showroom Other (Property Management / School / Church / Business / Hospital / Etc.)

Business Breakdown:

Changeout %:

Service %:

Residential New Construction %:

Commercial %:

Type of Business: Corporation Sole Proprietor Municipality Partnership

Plumber License #:

HVAC License #:

Electrican License #:

Purchases taxable? Yes No

If no, completed tax exemption certificate must be attached or sales tax will be charged.

Estimate of Monthly Purchases:

Estimate Yearly Purchases:

Is purchase order required?
Yes No

Credit Requested:

Business Building is:
Owned Rented/Leased

Rented/Leased From:

Are there any past due taxes owed by applicant to taxing authorities? Yes No

Has a tax lien or civil suit been filed against applicant or any of its owners, principals, partners, officers, or directors within the past six years? Yes No

Is applicant or any of its owners, principals, partners, officers, or directors a guarantor or endorser of debts owed by others? Yes No

Has applicant or any of its owners, principals, partners, officers, or directors ever filed fo bankruptcy or been adjudged bankrupt?
Yes No

If yes, when?

Year Business Started:

If in business less than one year, name and address of previous employer or previous business:

Name and phone number of person responsible for paying bills:

Supplier References

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Account Number:

Account Type:

Owners(s), Partners, or Corporate Officers

Name:

Title:

Address:

Phone:

Name:

Title:

Address:

Phone:

Name:

Title:

Address:

Phone:

In consideration of the extension of credit by Sanders Supply, Inc. (hereafter referred to as Sanders), the undersigned agrees:

To pay the balance of the account in full on the designated date following the date of purchase.
To pay service charges on any delinquent amounts at the maximum rate prescribed by state law.
To pay all reasonable charges for collection, including attorney fees and court costs, if the account is placed with an attorney or collection agency.
That standard terms and conditions set forth on invoices shall govern all sales to the undersigned.
That in the event a legal action is commenced solely to enforce any of the terms of purchase or obligations created hereby or hereinafter, the legal action will be commenced in, and the proper place of trial therefore shall be, a court of competent jurisdiction in the county in which the distributing warehouse is located.
To provide Sanders with a list of parties authorized to charge on the account. If no list is provided, undersigned agrees that Sanders may rely upon all reasonable representations of persons representing themselves to be authorized agents with authority to make purchases against the account.
To inform Sanders immediately of any changes in this information or in my/our financial status or my/our interest or position in any partnerships or corporations which purchase materials from Sanders.
To authorize any of the bank or trade references listed in this application to provide Sanders with any and all information requested.

By signing below, the undersigned acknowledges, accepts, and agrees to Sanders terms and conditions and certifies that the information given herein is true and correct.

Company Name:

Date:

Signature:

Date:

Signature:

Date:

Federal I.D. Number:

Social Security Number:

Continuing Guarantee

In consideration of Sanders extending credit hereunder, the undersigned personally, jointly, and severally and unconditionally guarantee and promise to pay Sanders on demand, any and all indebtedness of the above-named applicant to Sanders. This is a continuing guarantee and the obligations created hereby are unaffected by any change in the terms of the original indebtedness between Sanders and above-named applicant, save that of payment. This guarantee shall continue in effect until the undersigned has notified Sanders in writing of its cancellation, but such cancellation shall not alter any obligation of the undersigned prior to receipt of such written notice.

Signature:

Date:

Signature:

Date:

Note: In the event that Sanders offers extension of credit to the above-named credit applicant and/or guarantors on the above terms or in any other terms agreed to by said applicant and Sanders, said extension of credit is issued pursuant to the information and financial representations made herein by said applicant and or said guarantors.

ALL INFORMATION ON THIS APPLICATION WILL BE TREATED AS STRICTLY CONFIDENTIAL. THANK YOU.