Email to: abcpump@sbcglobal.net

DATE:_______________________________________

COMPANY NAME_____________________________ PHONE______________

STREET ADDRESS_____________________________ FAX_________________

MAILING ADDRESS____________________________ YEARS IN BUSINESS________________

CITY_________________________________________ STATE______ ZIP__________________

FULL NAME OF OWNER: _______________________________________________________________

TYPE OF OWNERSHIP INDIVIDUAL PARTNERSHIP CORPORATION LLC

CONTRACTORS LICENSE NUMBER_________________________________

SOCIAL SECURITY NUMBER_______________________________________

OR FED. I.D. NUMBER_____________________________________________

ARE PO NUMBERS REQUIRED YES_____ NO_____

INVOICES FAXED___ E-MAILED ____ OR MAILED______

E-MAIL ADDRESS AP___________________________ PURCHASING______________________

TRADE REFERENCES

NAME ___________________________ NAME ____________________________

PHONE ___________________________ PHONE ____________________________

FAX ___________________________ FAX ____________________________

E-MAIL___________________________ E-MAIL ____________________________

NAME ___________________________ NAME ____________________________

PHONE ___________________________ PHONE ____________________________

FAX ___________________________ FAX ____________________________

E-MAIL___________________________ E-MAIL ____________________________

BANK REFERENCE: TAX RESALE NUMBER:

NAME ___________________________ ________________________________________

ADDRESS, CITY, STATE & ZIP________________________________________________________

PHONE ___________________________ FAX# _________________________

ACCOUNT # _________________________________________________________

THIS APPLICATION MUST BE SIGNED ON REVERSE SIDE OR SECOND PAGE

THE UNDERSIGNED HERE BY CERTIFIES THE ABOVE INFORMATION IS TRUE AND CORRECT. THIS APPLICATION IS SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AUTHORIZES RELEASE OF CREDIT INFORMATION FROM LISTED REFERENCES, BANKING REFERENCES, AND AGREES TO ALL CONDITIONS OF SALE OF ABC PUMP SERVICE & REPAIR, INCLUDING THE TERMS BELOW AND THE TERMS CONTAINED ON INVOICES AND STATEMENTS AND ANY REVISIONS THERE TO. THE PURCHASER AGREES THAT ALL SALES MADE HERE UNDER ARE CONDITIONAL SALES CONTRACTS AND THAT TITLE TO THE MERCHANDISE REMAINS WITH THE VENDOR UNTIL PAID IN FULL. THE PERSON EXECUTING THIS AGREEMENT HAS THE AUTHORITY TO BIND THE CUSTOMER AND IS AUTHORIZED BY THE CUSTOMER TO ENTER INTO THE CREDIT APPLICATION TERMS AND CONDITIONS.

SIGNED____________________________________TITLE______________________DATE__________

TERMS, CONDITIONS AND RETURN MATERIAL POLICY

PAYMENT TERMS ARE 2% 10^TH OF PROXIMATE MONTH, NET 25^TH. ANY DISCOUNT TAKEN ON PAYMENTS RECEIVED AFTER THE 10^TH WILL BE DISALLOWED. FOR BILLING AND PAYMENT PURPOSES EACH MONTH ENDS ON THE 25^TH DAY OF EACH MONTH. REMIT PAYMENTS TO –

ABC PUMP SERVICE & REPAIR 2042 E. ORANGE GROVE AVE. ORANGE CA. 92867.

ALL PAYMENTS WILL APPLY TO SERVICE CHARGES FIRST

INVOICES ARE MAILED OR FAXED PERIODICALLY DURING THE MONTH. STATEMENTS ARE PREPARED ON THE COMPLETION OF THE MONTHLY BILLING CYCLE (25^TH OF THE MONTH).

PAST DUE ACCOUNTS WILL BE LEVIED AND FINANCE CHARGE OF 2% PER MONTH.

RETURNED CHECKS WILL INCUR A $30.00 CHARGE THE FIRST TIME AND A $35.00 EACH TIME THERE AFTER.

NON-COMPLIANCE WITH PAYMENT TERMS WILL RESULT IN CANCELLATION OF CREDIT PRIVILEGES.

RETURNS MUST BE ACCOMPANIED BY A COPY OF THE ORIGINAL PURCHASE INVOICE, MUST BE ORIGINALLY PACKAGED AND MUST BE IN GOOD AND UNUSED CONDITION AND REPAIR. RETURN MERCHANDISE IS SUBJECT TO A RE-STOCKING, CLEANING AND/OR REFURBISHING CHARGES. NO CASH REFUNDS ALL CREDITS ARE TO BE APPLIED TO FUTURE PURCHASES. CREDITS NOT USED WITHIN 12 MONTHS WILL BE VOIDED.

ALL CLAIMS MUST BE MADE WITHIN 10 DAYS OF PURCHASE.

COLLECTION EXPENSES, COURT COST AND ATTORNEYS FEES INCURRED IN THE COLLECTION OF OVERDUE ACCOUNTS WILL BE BORNE BY THE PURCHASER 100%.

ABC PUMP SERVICE & REPAIR

RESERVES THE RIGHT TO REQUIRE FULL OR PARTIAL PAYMENT IN ADVANCE OF SHIPMENT, TO ESTABLISH CREDIT LIMITS, TO ASSIGN OVERDUE ACCOUNTS FOR COLLECTIONS, TO DENY CREDIT AND/OR TO CANCEL CREDIT PRIVILEGE AT ITS SOLE DISCRETION.