Credit Application Agreement
RJ Enterprise, Inc.
185 S. Bedlam Rd.
Mansfield Ctr, CT 06250
Tel: 800-277-9979
Fax to: 860-455-2109
Please print this
confidential application and then Fax to
our office for processing. Thank you.
Buyer Name:
________________________________________ Phone: (______) ______- ________
Company Name:
____________________________________________
Billing PO/Street:
_______________________________________ Fax: (______) ______-________
Shipping Address:
___________________________________________
City / State / ZIP:
_______________________________________________ DUNS # __________
Accounts Payable Contact:
___________________________ Phone: (______) ______- ________
BANK REFERENCE
Checking Acct Bank:
____________________________________________
Account #:_________________________
Street:
_______________________________________
City / State / Zip:
_______________________________ Phone: (______) ______-________
TRADE CREDIT REFERENCES
1) Vendor:
______________________________________ Contact:______________________
Street:
_______________________________________ Phone: (______) ______-________
City / State
/ Zip: _______________________________
2) Vendor:
______________________________________ Contact:______________________
Street:
_______________________________________ Phone: (______) ______-________
City / State
/ Zip: _______________________________
3) Vendor:
______________________________________ Contact:______________________
Street:
_______________________________________ Phone: (______) ______-________
City / State
/ Zip: _______________________________
This Credit Application and Agreement is submitted by
Buyer to RJ Enterprise, Inc (Seller) to obtain trade credit. Buyer agrees to make
payment in full to Seller for all amounts due according to Seller’s Invoice(s).
Buyer agrees that payments are due within 30 days of Invoice(s).
Buyer also agrees to pay to Seller, as interest equal to 1.5% per month or the
maximum provided by law (which ever is less) for invoice amounts that are past
due. In the event Seller should commence any action or otherwise seek to enforce
this agreement against Buyer, Buyer agrees to pay reasonable attorney(s) fees,
court costs and other expenses, incurred by Seller, whether or not suit is
filed. This agreement is not transferable or assignable without prior written
consent of Seller.
Dated at
____________________________________, as of this ______day of
____________________, 200__.
Signature of Buyer: ____________________________________
Printed Name: ________________________________________ Title:
________________________________