Credit ApplicationCredit Application123456Company/Applicant InformationPlease complete this form if you are interested in applying for credit. To complete the application credit, you will need (1) Company Information (2) Owner/Officer Contact Information (3) Trade References (4) Bank and Bonding Company Information (5) Guarantor InformationCompany Name(Required)Fed ID(Required)Company Address(Required)City(Required)State(Required)State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip(Required)Phone Number(Required)Fax NumberBilling Address(Required)City(Required)State(Required)State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip(Required)Phone Number(Required)Fax NumberContact Email(Required) Company Type(Required)Company Type*IncorporatedCorpLLCPartnershipSole ProprietorshipYear Established(Required)Business Type(Required)Website URLHave you bought from Ernest Maier before?(Required)Have you bought from Ernest Maier before?*YesNoPlease provide date of purchase & amountTax Exempt?Tax Exempt?YesNoAttach tax exempt formMax. file size: 100 MB.Preferred Sales Rep?Owner/Officer InformationOfficerOfficer*(Required)Role*(Required)Phone Number*(Required)Email*(Required) + Add Another Officer- Remove OfficerPayables Contact(Required)Phone Number(Required)Email(Required) Have any of the companies or people listed ever been a debtor in a bankruptcy proceeding? Yes NoAre there legal actions or arbitrations pending against any of the companies or people listed? Yes NoTrade ReferencesReferenceReference #Company*(Required)Sells*(Required)City*(Required)State(Required)State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPhone Number*(Required)Fax Number+ Add Another Reference- Remove ReferenceBank & Bonding Company InformationBank Information (required)Bank Name(Required)Account(Required)Contact(Required)Phone Number(Required)Bonding Information (optional)Bonding CompanyBond#Contact*Phone NumberAdditional InformationAdditional informationCredit AgreementRequested Credit Line(This does not limit financial liability on this account).Requested Credit Line(Required)Terms and Conditions of Credit AgreementIt is understood that in consideration for extending a credit account the Seller (Ernest Maier, Inc. & dba as Parker Block, Skyline Brick, Bay Ready Mix of Maryland, and Gomoljak Block) and Customer agree upon the following terms and conditions:TermsAll accounts are due and payable thirty (30) days from the date of the invoice.InterestAny account remaining unpaid sixty (60) days from date of invoice will be addressed service charges of 1.5% per month (an effective annual rate of 18%). Interest will accrue from the date of invoice.FeesIn the event of legal action, Customer shall be responsible for paying reasonable Attorney’s fees incurred by Ernest Maier.PaymentsCustomer agrees that Seller has the right to determine how to apply payments and which invoices to pay with all payments received on this account.Account StatusSeller may stop the sale or supply of any materials when it determines that Customer is in breach of this Agreement or Seller has concerns about Customer’s creditworthiness, until payment is made and any dispute or insecurity has been resolved.Refunds/Returns/CreditsCustomer agrees that refunds/returns/credits not applied six (6) months from invoice date expire. Seller has the right to determine how to apply returns/credits on the account as it sees fit after 90 days.Releases/WaiversAll waivers executed by Seller shall be effective only to the total dollar amount of payments actually received. Customer agrees that Seller does not release its mechanic’s lien, payment bond or other legal rights for unpaid invoices, regardless of what other documents have been presented to Seller for signature that may imply otherwise.DeliveryAny deliveries made are to be within the normal weekday and Seller does not guarantee delivery times or rates.Terms and ConditionsConsent(Required) By checking this box, I agree to the listed terms and conditions.(Required)It is understood that in consideration for extending a credit account the Seller (Ernest Maier, Inc. & dba as Parker Block, Skyline Brick, Bay Ready Mix of Maryland, and Gomoljak Block) and Customer agree upon the following terms and conditions: - TERMS All accounts are due and payable thirty (30) days from the date of the invoice. - INTEREST Any account remaining unpaid sixty (60) days from date of invoice will be addressed service charges of 1.5% per month (an effective annual rate of 18%). Interest will accrue from date of invoice. - FEES In the event of legal action, Customer shall be responsible for paying reasonable Attorney’s fees incurred by Ernest Maier. - PAYMENTS Customer agrees that Seller has the right to determine how to apply payments and which invoices to pay with all payments received on this account. - ACCOUNT STATUS Seller may stop the sale or supply of any materials when it determines that Customer is in breach of this Agreement or Seller has concerns about Customer’s creditworthiness, until payment is made and any dispute or insecurity has been resolved. - REFUNDS/RETURNS/CREDITS Customer agrees that refunds/returns/credits not applied six (6) months from invoice date expire. Seller has the right to determine how to apply returns/credits on the account as it sees fit after 90 days. - RELEASES/WAIVERS All waivers executed by Seller shall be effective only to the total dollar amount of payments actually received. Customer agrees that Seller does not release its mechanic’s lien, payment bond or other legal rights for unpaid invoices, regardless of what other documents have been presented to Seller for signature that may imply otherwise. - DELIVERY Any deliveries made are to be within the normal weekday and Seller does not guarantee delivery times or rates.Signature(Required)Signer Name(Required)Signer Title(Required)Signed Date(Required) MM slash DD slash YYYY Credit application not accepted without approval from Ernest Maier, Inc.’s Credit DepartmentPersonal GuaranteeIn consideration for, and as an inducement to the Seller (Ernest Maier, Inc. & dba as Parker Block, Skyline Brick, Bay Ready Mix of Maryland, and Gomoljak Block) to extend credit to the individual owner/officer named above (hereinafter “Customer”), the undersigned Guarantors hereby personally guarantee to Seller the payment of any obligation of the Customer, and agree to pay Seller on demand any sum which may become due by the Customer whenever the Customer shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable guarantee and indemnity for such indebtedness of the Customer. Written notice of termination of the Personal Guarantee is required by Ernest Maier Inc. Guarantors do hereby waive notice of default, nonpayment and notice hereof and consent to any modification or renewal of the credit agreement. *Guarantor must be listed in the owner/officer contact information*Guarantor #1 - Signature(Required)Guarantor #1 Name(Required)Signed Date(Required) MM slash DD slash YYYY Guarantor #2 - Signature (optional)Guarantor #2 NameSigned Date MM slash DD slash YYYY