New Account Application

Please fill out this form to submit your Account Application. Required fields are marked with *

COMPANY INFORMATION
Amount of Credit Requested:  *
PO/SM/Statement:  
Business Type:  
Name of Business ("Applicant"):*  
Billing Address:*  
Billing City, State, Zip:*  
Delivery Address:*  
Delivery City, State, Zip:*  
Will Your Orders Be Primarily:  Will Call    Shipped
Phone Number:*  
Fax Number:  
Email Address:*  
Accounts Payable Contact:*  
People Authorized to Place Orders:  
Type or Nature of Business:  
Years in Business:  
Number of Employees:  
Do you currently:  Rent Building    Own Building
Federal Tax Number (for corp):  
NAMES OF CORPORATE OFFICERS, PARTNERS, OR OWNER
OFFICER 1 (required)
Name & Title:*  
Phone Number:*  
Address:*  
City, State, Zipcode:*  
Social Security Number:*  
Spouse's Name  
OFFICER 2
Name & Title:  
Phone Number:  
Address:  
City, State, Zipcode:  
Social Security Number:  
Spouse's Name  
OFFICER 3
Name & Title:  
Phone Number:  
Address:  
City, State, Zipcode:  
Social Security Number:  
Spouse's Name  


BOND INFORMATION
Contractor's License Number:  
State:  
Expiration Date:  
Bonding Company:  
Bond Number:  
Address:  
City, State, Zip:  
Amount of Bond:  
Claims Against Bond:  
Assignment of Savings?:  Yes    No
BANK REFERENCES
Bank:*  
Branch:  
Bank Officer:  
Account Number:  
Bank Phone:  
Account Type:  Checking    Savings    Loan   

Applicant acknowledges that this information has been submitted with the knowledge that it will be used in evaluating the extension of credit to the applicant. Applicant acknowledges that T&A Supply Company, Inc., and/or T&A Trym-Tex, LLC (the Company) may inquire with third parties, including credit agencies and banks, for Applicant's and/or Applicant's principal(s)' credit history and credit information to make any credit decision. Applicant and/or Applicant's principal(s) authorize any third party, including credit agencies and banks, to release credit information.
 I agree to these terms*

Are there any of the following security arrangements presently in effect for your business entiry?
 UCC-1     SBA Loan     Corporation and/or Personal Guarantee by Officers and/or Owner

Are accounts receivable, inventories, or fixed assets pledged as collateral?
 Yes    No

TRADE REFERENCES
Reference 1
Name:*  
City, State:*  
Phone Number:*  
Fax Number:  
Account Number:  
Reference 2
Name:  
City, State:  
Phone Number:  
Fax Number:  
Account Number:  
Reference 3
Name:  
City, State:  
Phone Number:  
Fax Number:  
Account Number:  
Reference 4
Name:  
City, State:  
Phone Number:  
Fax Number:  
Account Number:  
Reference 5
Name:  
City, State:  
Phone Number:  
Fax Number:  
Account Number:  
SALES AGREEMENT
  1. I/We make application to the seller for credit/or to obtain further credit with the seller. I/We certify that the information supplied is true and correct to the best of my/our knowledge and further agree that a facsimile shall be as binding as an original signature.
  2. I/We promise to pay my/our account in full on or before the due date as defined on each invoice; verbal quotes on price & terms are not valid. Further, I/We agree to pay any and all late charges assessed at the rate of 18% per annum on past-due balances.
  3. I/We agree to be liable for all costs and expenses, including, but not limited to attorneys' fees, legal expenses, & collection agency fees, incurred by the Seller in collecting amounts owed by Applicant, in enforcing any terms of the sales agreement, in responding to defenses, affirmative defenses and/or counterclaims raised by Applicant.
  4. If any term of this agreement is invalid, the invalid term shall be considered deleted from this agreement and shall not invalidate any other term(s).
  5. Venue and jurisdiction of any suit or legal action may be had in Seattle, King County, Washington at the sole option of the seller.
  6. I/We agree to notify the seller in writing prior to any changes in ownership, billing address, or authorized buyers.
  7. I/We acknowledge that the seller makes no warranty or guarantee expressed or implied beyond those stated by the manufacturer. THE SELLER DOES NOT WARRANT THE FITNESS OR MERCHANTABILITY OF ANY GOODS.
  8. Applicant is solvent at this time and agrees to notify the seller if Applicant's financial position changes and is unable to meet it's obligations.
  9. The seller may terminate any credit terms and/or credit amount of anytime within its sole discretion.
  10. This credit application and any rights arising under it may be assigned to another party by the seller at anytime without Applicant's consent. Applicant may not assign its obligations to the seller without prior written consent within maybe withheld for any reason.
  11. My/Our agreement below serves as consent for the seller to access personal and business credit information for the purpose of determining my/our credit standing in conjunction with opening a business credit account for which I am solely liable or have personally guaranteed.
  12. In the event this application is made by individuals, or a partnership or is personally guaranteed by individuals, the applicant and any guarantors acknowledge and agree that any credit to be extended by the seller to the applicant will be business or trade debt, and shall not be for personal family or household use.
  13. ORAL AGREEMENTS OR ORAL COMMITMENTS TO EXTEND CREDIT, OR TO FORBEAR FROM ENFORCING REPAYMENT OF A DEBT ARE NOT ENFORCEABLE UNDER WASHINGTON LAW, RCW 19.363110. THE SELLER WILL NOT BE BOUND BY ANY ORAL STATEMENT.
 I agree to the above statements*
Name 1:  *
Name 2 (optional):  
Date:  *


PERSONAL GUARANTEE
  1. The undersigned, an officer or owner of said business for which application for credit is being made, and in consideration of the extension of said credit availability by Seller does hereby absolutely and unconditionally guarantee, on a continuing basis, the performance of all obligations of the person(s) and/or entity(ies) that signed the appended sales agreement and any and all obligations owed to the Seller including but not limited to the prompt payment of all present and future indebtedness.
  2. This guarantee is irrevocable and is binding on Guarantor and Guarantor's heirs, successors and assigns so long as any indebtedness remains unpaid or obligation unfulfilled. The guarantee shall continue in effect until the undersigned has notified the Seller in writing of its cancellation, but such cancellation shall not alter any obligation of the undersigned arising hereunder prior to the receipt of written notice.
  3. Guarantor agrees to pay all of the Seller's costs and expenses, including, but not limited to attorneys' fees, legal expenses, & collection agency fees, incurred by the Seller in collecting amounts owned by Applicant and/or Guarantor, and/or enforcing any term of this personal guarantee.
  4. The undersigned further acknowledges and represents that any titles written near the signatures below is/are intended merely to clarify the individual's position with the Applicant and in no way is intended to limit or cancel the personal nature of this guarantee.
 I agree to the above statements
Name 1:  
Name 2 (optional):  
Date:  
Address:  
City, State:      Zip: