Concrete Reinforcing Wire, Reinforcing Steel Rebar

Company Information:

Company Name:	*
Date Established:	*
Mailing Address:	*
City:	*
State:	*
Zip Code:	*
Business Phone:	*
Alternate Phone:	*
Cell Phone:	*
Business Fax:	*
Shipping Address:
City:
State:
Zip Code:

Type Of Business:

Business Ownership:

Sole Proprietorship

Partnership

Corporation *

State Incorporated:	*
Business License #:	*
Contractors License #:	*

Credit Request:

Accounts Payable Contact:
Sales Tax Status:

Exempt:

Yes

(If Sales Tax Exempt, Resale Card must be submitted.)

Owner/Officer Information:

Owners/Officers:	*	Owners/Officers:
Title:	*	Title:
Home Address:	*	Home Address:
City:	*	City:
State:	*	State:
Zip Code:	*	Zip Code:
Phone:	*	Phone:
Fax:	*	Fax:

Bank Information:

Bank Name:	*
Officer:	*
Phone:	*
Fax:	*

(Bank Account Number is required to complete credit application.
Please call Anna or Dawn in the Accounting Office at (818) 886-5601)

Address:	*
City:	*
State:	*
Zip Code:	*

Trade Reference:

Company Name:	*	Company Name:
Address:	*	Address:
City:	*	City:
State:	*	State:
Zip Code:	*	Zip Code:
Phone:	*	Phone:
Fax:	*	Fax:

Company Name:		Company Name:
Address:		Address:
City:		City:
State:		State:
Zip Code:		Zip Code:
Phone:		Phone:
Fax:		Fax:

Terms And Conditions Of Sale:

Net 10th Day from the date of invoice(s) to all approved customers with open credit. All past due balances will be subject to a service charge of 1 1/2% per month. In the event of default payment(s), any and all reasonable incurred attorney fees and court costs will be added to the total balance owed.

All information provided in this application is true and correct, I authorize Bellis Steel Company, Inc. and/or any of its affiliates to request open credit related information from trade references, bank information and/or credit reporting agencies or bureaus.

Authorized By (Your Name)

Title

Date

Guarantee Agreement:

IN CONSIDERATION OF BELLIS STEEL COMPANY, INC. OR ANY AFFILIATES AGREEING TO SELL GOODS ON AN OPEN ACCOUNT TO * ("BUYER"), I/WE, THE UNDERSIGNED, JOINTLY AND SEVERALLY, HEREBY GUARANTEE AMOUNTS EXCEED STATED CREDIT LIMITS, AND OF ALL (LEGAL) FEES AND EXPENSES INCURRED BY BELLIS STEEL COMPANY, INC. IN THE EXTENT AS BUYER, AND THESE OBLIGATIONS SHALL BE BINDING ON THE HEIRS, ADMININSTRATORS, SUCCESSORS AND ASSIGNS OF THE UNDERSIGNED. THE UNDERSIGNED EXPRESSLY WAVE NOTICE OF ACCEPTANCE OF THIS GUARANTEE, AND PROMPTNESS, PRESENTMENT, DEMAND, PROTEST AND NOTICE OF DISHONOR OF OBLIGATIONS HEREBY GUARANTEE BELLIS STEEL COMPANY, INC. TO OBTAIN ANY PERSONAL CREDIT INFORMATION ABOUT BUYER OR GUARANTOR FROM ANY ENTITY.

Guaranteed By:	*	Date:	*
Guaranteed By:		Date:

Upon receiving this Credit Application by email, Bellis Reinforcing Steel will start the application process. However, we will not be able to open your account until a copy of the SIGNED application is received. Bellis Reinforcing Steel will contact you shortly to make arrangements to receive your SIGNED application by fax or by mail.

* Required Information