Credit Application
Business Name
Billing Address City ST Zip
Phone Fax Contact
Shipping Address
City ST Shipping Address Phone
OWNERSHIP Sole Owner   Partnership   Corporation   
YEAR BUSINESS STARTED SALES TAX: Tax Exempt   Taxable   
*IF EXEMPT, PLEASE SEND VALID TAX CERTIFICATES

BANK INFORMATION
Bank Name City ST Zip
Phone Fax City ST Zip
Contact
CREDIT REFERENCES
Name City State Zip Phone Fax
Name City State Zip Phone Fax
Name City State Zip Phone Fax
AGREEMENT
I hereby authorize the above named Bank and trade references to release to Roofing & Insulation Supply, Inc. upon its request. The authorization to secure this information shall continue as long as above company remains a customer of Roofing & Insulation Supply, Inc.

I acknowledge and agree that Roofing & Insulation Supply, Inc.’s terms and conditions of sale shall govern and control all transactions between the parties, and that a copy of such terms and conditions are available from Roofing & Insulation Supply, Inc. upon request.

I certify that the information submitted on this credit application is true and accurate, and I am authorized to sign on behalf of the Company.

Any invoices not paid when due will be subject to a finance charge up to 1½% per month, not to exceed the maximum rate permitted by law.
Individual Name: Date:
PERSONAL GUARANTEE
The undersigned individually and personally, jointly and separately, in order to induce Roofing & Insulation Supply, Inc. to extend credit to the above named applicant(s), agrees to endorse and to guarantee to pay on demand any sum due Roofing & Insulation Supply, Inc. by the above applicant(s). Roofing & Insulation Supply, Inc. reserves the right to proceed directly against the named guarantor without having to proceed first against the above named applicant or liquidate any security given by said applicant(s). The undersigned guarantor hereby agrees to allow Roofing & Insulation Supply to perform an investigation on said guarantor’s personal credit history from an independent source.

Guarantor’s Name:
Address: Date:
Guarantor’s Name:
Address: Date:
Location:
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