Credit Application
WWW.VHRRENTAL.COM
508 Berlin Rd
Voorhees, NJ, 08043
Phone: (856) 429-7839
Fax: (856) 429-4826
800 S. RT. 73
West Berlin, NJ, 08091
Phone: (856) 753-5400
Fax: (856) 753-5433
CREDIT APPLICATION
1.CORPORATION NAME OR TRADE STYLE: ______________________________________
ADDRESS:______________________________________________________________
***NO CREDIT APPLICATIONS CAN BE CONSIDERED WITHOUT A PHYSICAL STREET OFFICE LOCATION/ADDRESS. (P.O. BOXES DO NOT QUALIFY)
PHONE: ______________________________FAX: _________________________________
2. TYPE OF ORGANIZATION:
( ) CORPORATION ( ) PARTNERSHIP ( ) INDIVIDUAL
ARE YOU TAX EXEMPT: ( ) YES ( ) NO
IF YES, SEND NJ TAX EXEMPT FORM
TYPE OF BUSINESS:__________________DATE ESTABLISHED:_________________
PRINCIPALS:(OFFICERS)___________________________________________
DO YOU ISSUE PURCHASE ORDERS? ( ) YES ( ) NO
PURCHASING AGENT OR MANAGER:________________________________________
NAME OF EACH PERSON AND TITLE AUTHORIZED TO MAKE PURCHASES:
__________________________________________________________________
NAME OF OFFICIAL AND TITLE RESPONSIBLE FOR PAYMENT OF ACCOUNT:
__________________________________________________________________
3. BANK ACCOUNTS:
(1) NAME:__________________________ (2) NAME:__________________________
ADDRESS:_____________________________ ADDRESS:___________________________
CITY, STATE, & ZIP: ____________________CITY, STATE, & ZIP: _________________
PHONE NUMBER:_______________________ PHONE NUMBER:_______________________
EMAIL ADDRESS:_______________________ EMAIL ADDRESS:_______________________
TYPE OF ACCOUNT: ____________________ TYPE OF ACCOUNT: ____________________
4. RENTAL YARD CREDIT REFERENCES:
(1) NAME: __________________________ (2) NAME: ________________________
ADDRESS: _____________________________ ADDRESS: ___________________________
CITY, STATE, & ZIP: ____________________CITY, STATE, & ZIP: _________________
PHONE NUMBER:_______________________ PHONE NUMBER:_______________________
EMAIL ADDRESS:_______________________ EMAIL ADDRESS:_______________________
TYPE OF ACCOUNT: ____________________ TYPE OF ACCOUNT: ____________________
LENGTH OF RELATIONSHIP: ___________ LENGTH OF RELATIONSHIP____________
5. SUPPLIER CREDIT REFERENCES:
(1) NAME: __________________________ (2) NAME: ________________________
ADDRESS: _____________________________ ADDRESS: ___________________________
CITY, STATE, & ZIP: ____________________CITY, STATE, & ZIP:_________________
PHONE NUMBER:_______________________ PHONE NUMBER:_______________________
EMAIL ADDRESS:_______________________ EMAIL ADDRESS:_______________________
TYPE OF ACCOUNT: ____________________ TYPE OF ACCOUNT:____________________
LENGTH OF RELATIONSHIP: ___________ LENGTH OF RELATIONSHIP____________
(3) NAME: __________________________ (4) NAME: ________________________
ADDRESS: _____________________________ ADDRESS:_______________________
CITY, STATE, & ZIP: __________________ CITY, STATE, & ZIP:__________________
PHONE NUMBER:_______________________ PHONE NUMBER:_______________________
EMAIL ADDRESS:_______________________ EMAIL ADDRESS:_______________________
TYPE OF ACCOUNT: ____________________ TYPE OF ACCOUNT:____________________
LENGTH OF RELATIONSHIP: ___________ LENGTH OF RELATIONSHIP____________
6. IN CONSIDERATION FOR GRANTING OF CREDIT BY VOOHEES HARDWARE & RENTAL INC., WE AGREE TO THE FOLLOWING:
(A) I AM AUTHORIZED TO OBTAIN CREDIT FOR OUR COMPANY. ALL STATEMENTS MADE HEREIN ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE VOORHEES HARDWARE AND VHR RENTAL INC. TO MAKE ANY AND ALL INQUIRIES NECESSARY FOR ACTION ON THIS CREDIT APPLICATION.
(B)THAT THE INFORMATION PROVIDED HEREIN BY US (ME) IS ACCURATE.
(C)THAT VOORHEES HARDWARE & RENTAL INC. WILL RELY ON SAID INFORMATION IN GRANTING CREDIT,
(D)THAT WE (I) SHALL PAY ALL CHARGES WITHIN VOORHEES HARDWARE & RENTAL INC. TERMS (NET CASH)
(E)THAT WE (I) AGREE TO PAY A MONTHLY SERVICE CHARGE OF 1 ˝ % PER MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% FOR EACH MONTH FOLLOWING THE DUE DATE THAT AN INVOICE REMAINS UNPAID.
(F)THAT WE (I) AGREE THAT THE PAYMENT OF SAID SERVICE CHARGE DOES NOT EXTEND THE TIME WITHIN WHICH WE (I) ARE OBLIGATED TO PAY SUCH INVOICE AMOUNT.
(G)THAT WE (I) AGREE TO PAY IN ADDITION TO ANY ACCRUED SERVICE CHARGES AND THE INVOICE AMOUNT. ANY EXPENSES INCLUDING REASONABLE ATTORNEY’S FEES, WHICH VOORHEES HARDWARE AND RENTAL INC. MAY INCUR WITH RESPECT TO THE COLLECTIONS OF ANY AMOUNT IS DUE FROM US (ME).
(H)CUSTOMER AGREES TO PAY FOR ANY DAMAGE TO OR LOSS OF EQUIPMENT REGARDLESS OF CAUSE, EXCEPT REASONABLE WEAR AND TEAR, WHILE EQUIPMENT IS IN THE POSITION OF THE CUSTOMER. ONCE THE EQUIPMENT LEAVES VOORHEES HARDWARE & RENTAL INC., YOU ARE COMPLETELY RESPONSIBLE FOR IT, UNTIL WE PICK IT BACK UP AND YOU HAVE A PICK UP RECEIPT IN YOUR HANDS.
DATED THIS: ________DAY OF______________20___
CUSTOMER SIGNATURE:______________________________
PLEASE PRINT ABOVE NAME:_________________________
TITLE: _______________________________________________
APPROVED:
VHR Rental / Voorhees Hardware Inc.
BY: ___________________________ DATE: ___________
***PLEASE ADDRESS ALL CORRESPONDENCE TO THE 508 BERLIN ROAD, VOORHEES, NJ 08043 ***
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