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Customer Credit Application

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Do not press enter until form is completely filled out.

Company
Corporation:    Yes No   State of Incorporation:
Owner / Partnership (Names)
Billing Address:
Physical Address:
Phone No: Fax No:
Contractor's License No: Purchase Order Required: Yes No

BANK REFERENCES: Name:
             Address: Contact:
             Account No: Phone No:

Trade References:

1. Name:
   Address
   Phone No: Fax No:

2. Name:
   Address
   Phone No: Fax No:

3. Name:
   Address
   Phone No: Fax No:

The above information is supplied for the purpose of obtaining credit information which is true and complete.  I understand the terms of sale on open account to be net 45 days and a finance charge of 2.0% per month will be charged on invoices not paid in 61 days form billing date.  In any action necessary to enforce this agreement, the customer will pay reasonable attorney's fees and costs as determined by the court. I further expressly consent CAL-WEST CONCRETE CUTTING, INC., to communicate with above mentioned creditors to establish this account

**RETENTION WILL NOT BE ACCEPTED**

Signature: Title:
E-mail:

P.O. Box 940,  Fremont CA 94537
(510) 656-0259 Fax (510) 656-8563

Credit Application processed with in 24 hour period  Monday - Friday
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