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Company Name:
Address:
City:
 State:
 Zip:
Phone:
 Fax:
 Email:
Kind of Buisness:
 Business Type:
Names of Principals and Titles:
First Name:
 Last Name:
 Title:
First Name:
 Last Name:
 Title:
First Name:
 Last Name:
 Title:
Length of Time in Business:
 Business Bank Reference:
Bank Address:
Bank City:
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Bank Phone:
 Bank Contact:
Credit References:
First Name:
 Last Name:
Address:
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 Phone:
First Name:
 Last Name:
Address:
City:
 State:
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First Name:
 Last Name:
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Anticipated credit required per month:
$ 		Salesman #:
Code Classification:
$ 		Account #:
Sales Tax Exempt:
Yes      No 

TERMS:
In the event it shall become necessary to emply counsel to collect overdue balances on any bill for materials, undersigned agrees to pay attorney's fees of 1/3 of the balance at the time counsel is employed plus all other expenses incurred in the collection of said overdue account balance plus interest on unpaid balance due,
In consideration of the extension of credit by C.N. Robinson to the above applicant it is understood and agreed that all invoices are due by the 25th of the following month and if not paid a 2% service charge will be attached.

AGREEMENT:
I/We authorize the release of credit information to C.N. Robinson to obtain credit information for the purposes of establishing credit. The undersigned further warrants and represents unto C.N. Robinson that the individuals executing this agreement are uathroized by the applicant to do so and to bind the applicant to the liabilities and obligations hereinbefore set forth.

Applicant Name (Signature):
 Title:

 

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© 2001 CNR Robinson Lighting and Supply Company
4318 Washington Blvd · Baltimore, Maryland 21227
(410) 242-4172 (D.C. & VA Area) 1-800-545-0441
FAX: (410) 644-8827 · (MD Area) 1-800-545-0440
questions or comments, email webmaster@cnrlight.com