Credit Application for a Business Account

CREDIT APPLICATION FOR A BUSINESS ACCOUNT BUSINESS CONTACT INFORMATION Company name: Contact name: Mailing Address: City: State: Zip: Delivery Address: City: State: Zip: Phone: Fax: E-mail: Sole proprietorship: Partnership: Corporation: Other: Years in Business: State Resale Tax No: Lines Handled: AC___ Case___ FD___ IH___ Referred By: JD___ MF___ White___ Other______Credit Limit Desired: BUSINESS/TRADE REFERENCES Company name: Address: City: State: Zip: Phone: Fax: E-mail: Type of account: Company name: Address: City: State: Zip: Phone: Fax: E-mail: Type of account: Company name: Address: City: State: Zip: Phone: Fax: E-mail: Type of account:

If you would like to open an Account on Terms of Net 30 Days for the purpose of ordering product from Speer Cushion Company, please complete the Credit Application and fax back to us at 970-854-2917 for Credit Approval.

We strive to offer Quality Products at Competitive Prices with Excellent Customer Service. We operate on a very narrow profit margin and require for all Invoices to be paid in a timely fashion. An Account that is Thirty (30) Days Past Due will be put on COD Status..

Any misrepresentation in the Credit Application will be considered evidence of fraud since this information is the basis for the extending of Credit to you. The undersigned warrants that the information submitted is true and correct.

In consideration for the extension of Credit, Your Company promises to pay for all purchases within the Net 30 Day Terms in agreement with our Credit Policy. In the event any third parties are employed to collect any outstanding monies owed by your Company, the undersigned agrees to pay reasonable collection costs, including attorney fees and all costs of litigation incurred. The undersigned represents that he/she has the authority to execute this Credit Agreement on behalf of the Business identified.

Signature Date