HAC Supply Credit Application
Heating & Air Conditioning Supply, Inc.
3880 Highway 81 South
Loganville, GA 30052
Phone: 678-639-0004 Fax: 678-639-0007
APPLICATION FOR CREDIT
Company Name____________________________________Main Business Activity______________________
Street Address___________________________________PO Box__________E-mail Address_______________
City/State/Zip__________________________Phone #____________________Fax #______________________
Sales Tax Permit #_________________(copy required) Federal ID #__________________Duns#_________
Ownership: Corporation___ Partnership___ Proprietorship___ L.L.C.___ State of Incorporation_______
How Long in Business_________
Credit Limit Requested: $___________________Estimated Monthly Purchase From Us: $______________
Proprietor, Partners, or Officers:
Name Home Address Phone Title Social Security #
Name Home Address Phone Title Social Security #
Accounts Payable Contact:____________________________ Purchasing Agent:_____________________
Bank Reference:
Bank____________________________Address________________________________City/State_____________
Phone #_______________ Fax #_____________Account #___________Bank Officer____________________
Checking___ Savings___ Business Loans___ Other________________________ Line of Credit___________
Trade References (Please fill out 3 references)
Name________________________Contact___________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Name________________________Contact___________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Name______________________Contact_____________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Agreement
Terms are stated on the invoice; all amounts are due in accordance with those terms. Should it be necessary to assign the account balance to a licensed collection agency/attorney for legal action, the applicant shall pay all subsequent collection charges/legal fees. The undersigned agrees to the terms and conditions stated herein. The undersigned hereby authorizes the above-mentioned bank/trade references to release information requested by Heating and Air Conditioning Supply, Inc.(H.A.C. Supply). Applicant’s signature attests financial responsibility, ability and willingness to pay in accordance with terms.
Name (Printed)_____________________________ Signature________________________Date_____________
Name (Printed)_____________________________Signature_________________________Date_____________
CONSENT TO OBTAIN CONSUMER CREDIT REPORT
The undersigned individual who is either a principal of the credit applicant or a sole proprietorship of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, hereby consents to and authorizes the use of a consumer report on the undersigned by Heating and Air Conditioning Supply, Inc. (H.A.C. Supply), from time to time as may be needed in the credit evaluation process.
___________________________________ ___________________________________________ _______________ Print Name Sign Name Date
____________________________________ __________________________________________ _______________ Print Name Sign Name Date
PERSONAL GUARANTEE I, _____________________________________________, for and in consideration of your extending
credit at my request to ______________________________________(the “Company”), personally guarantee prompt payment of any obligation of the Company to Heating and Air Conditioning Supply, Inc. (H.A.C. Supply, Inc.) (“Seller”), whether now existing or hereinafter incurred, and I further agree to bind myself to pay on demand any sum which is due by the Company to Seller whenever the Company fails to pay same. It is understood that this guaranty shall be an absolute, continuing and irrevocable guaranty for such indebtedness of the Company. I expressly waive presentment, demand, protest, notice of protest, dishonor, diligence, notice of default or nonpayment, notice of acceptance of this guaranty, notice of the extending of any guaranteed indebtedness already or hereafter contracted for by the Company, notice of any modification or renewal of any credit agreement evidencing the indebtedness hereby guaranteed, notice of any renewal of extension of such indebtedness, and I expressly consent to any modification or renewal of any credit agreement evidencing the indebtedness hereby guaranteed and to all renewals or extensions of such indebtedness. I further waive any right to require Seller to proceed against, or make any effort at collection of the guaranteed indebtedness from, the Company or any other party liable for such indebtedness. If the guaranteed indebtedness is not paid by me when due, and this guaranty is placed in the hands of an attorney for collection, or suit is brought hereon, or it is enforced through any judicial proceeding whatsoever, I shall pay all reasonable attorneys’ fees and court costs incurred by Seller. In the event more than one party executes this Guaranty as a guarantor, then each guarantor agrees to be jointly and severally liable for the guaranteed indebtedness, and, in all instances herein, the singular shall be construed to include plural. The undersigned personal guarantor, recognizing that his or her individual credit history may be a necessary factor in the evaluation of this personal guarantee, hereby consents to and authorizes the use of a consumer credit report on the undersigned, by the above named business credit grantor, from time to time as may be needed, in the credit evaluation process.
__________________________________________ ___________________________________ ________________
Sign Name Print Name Date
_________________________________________ ___________________________________ ________________
Sign Name Print Name Date
________________________________________
Witness
Please include a copy of EPA card and a copy of Conditioned Air License.
3880 Highway 81 South
Loganville, GA 30052
Phone: 678-639-0004 Fax: 678-639-0007
APPLICATION FOR CREDIT
Company Name____________________________________Main Business Activity______________________
Street Address___________________________________PO Box__________E-mail Address_______________
City/State/Zip__________________________Phone #____________________Fax #______________________
Sales Tax Permit #_________________(copy required) Federal ID #__________________Duns#_________
Ownership: Corporation___ Partnership___ Proprietorship___ L.L.C.___ State of Incorporation_______
How Long in Business_________
Credit Limit Requested: $___________________Estimated Monthly Purchase From Us: $______________
Proprietor, Partners, or Officers:
Name Home Address Phone Title Social Security #
Name Home Address Phone Title Social Security #
Accounts Payable Contact:____________________________ Purchasing Agent:_____________________
Bank Reference:
Bank____________________________Address________________________________City/State_____________
Phone #_______________ Fax #_____________Account #___________Bank Officer____________________
Checking___ Savings___ Business Loans___ Other________________________ Line of Credit___________
Trade References (Please fill out 3 references)
Name________________________Contact___________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Name________________________Contact___________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Name______________________Contact_____________________Phone_____________Fax #______________
Address_______________________________________ City/State ______________________ Zip_____________
Agreement
Terms are stated on the invoice; all amounts are due in accordance with those terms. Should it be necessary to assign the account balance to a licensed collection agency/attorney for legal action, the applicant shall pay all subsequent collection charges/legal fees. The undersigned agrees to the terms and conditions stated herein. The undersigned hereby authorizes the above-mentioned bank/trade references to release information requested by Heating and Air Conditioning Supply, Inc.(H.A.C. Supply). Applicant’s signature attests financial responsibility, ability and willingness to pay in accordance with terms.
Name (Printed)_____________________________ Signature________________________Date_____________
Name (Printed)_____________________________Signature_________________________Date_____________
CONSENT TO OBTAIN CONSUMER CREDIT REPORT
The undersigned individual who is either a principal of the credit applicant or a sole proprietorship of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, hereby consents to and authorizes the use of a consumer report on the undersigned by Heating and Air Conditioning Supply, Inc. (H.A.C. Supply), from time to time as may be needed in the credit evaluation process.
___________________________________ ___________________________________________ _______________ Print Name Sign Name Date
____________________________________ __________________________________________ _______________ Print Name Sign Name Date
PERSONAL GUARANTEE I, _____________________________________________, for and in consideration of your extending
credit at my request to ______________________________________(the “Company”), personally guarantee prompt payment of any obligation of the Company to Heating and Air Conditioning Supply, Inc. (H.A.C. Supply, Inc.) (“Seller”), whether now existing or hereinafter incurred, and I further agree to bind myself to pay on demand any sum which is due by the Company to Seller whenever the Company fails to pay same. It is understood that this guaranty shall be an absolute, continuing and irrevocable guaranty for such indebtedness of the Company. I expressly waive presentment, demand, protest, notice of protest, dishonor, diligence, notice of default or nonpayment, notice of acceptance of this guaranty, notice of the extending of any guaranteed indebtedness already or hereafter contracted for by the Company, notice of any modification or renewal of any credit agreement evidencing the indebtedness hereby guaranteed, notice of any renewal of extension of such indebtedness, and I expressly consent to any modification or renewal of any credit agreement evidencing the indebtedness hereby guaranteed and to all renewals or extensions of such indebtedness. I further waive any right to require Seller to proceed against, or make any effort at collection of the guaranteed indebtedness from, the Company or any other party liable for such indebtedness. If the guaranteed indebtedness is not paid by me when due, and this guaranty is placed in the hands of an attorney for collection, or suit is brought hereon, or it is enforced through any judicial proceeding whatsoever, I shall pay all reasonable attorneys’ fees and court costs incurred by Seller. In the event more than one party executes this Guaranty as a guarantor, then each guarantor agrees to be jointly and severally liable for the guaranteed indebtedness, and, in all instances herein, the singular shall be construed to include plural. The undersigned personal guarantor, recognizing that his or her individual credit history may be a necessary factor in the evaluation of this personal guarantee, hereby consents to and authorizes the use of a consumer credit report on the undersigned, by the above named business credit grantor, from time to time as may be needed, in the credit evaluation process.
__________________________________________ ___________________________________ ________________
Sign Name Print Name Date
_________________________________________ ___________________________________ ________________
Sign Name Print Name Date
________________________________________
Witness
Please include a copy of EPA card and a copy of Conditioned Air License.