**For Your Convenience We Also Accept Checks By Fax And Credit Card Payments**

Transcription

1 Revised SIGNATURE SPRINGS, LLC B I L L ATTENTION Account Information Form S H I P LEGAL BUSINESS NAME ADDRESS T O TRADE NAME KITCHEN CONTACT ADDRESS T O CITY, STATE, ZIP ACCOUNTING CONTACT PHONE CITY, STATE, ZIP PURCHASING CONTACT ACCOUNTING PHONE PURCHASING **For Your Convenience We Also Accept Checks By Fax And Credit Card Payments** Salesperson: : Requested Terms: *GENERAL INFORMATION: LTD Partnership List General Partner Corporation State Name and Address Tax ID#: of Registered Agent Proprietorship Partnership Franchise of Owner Purchase Length of Time in Business Bldg/Facilities: Owned Leased Landlord Name * Complete the following information for all Corporate Officers, Partners, or an Individual Proprietor: Name and Title Name and Title Home Address Home Address Home Phone Home Phone Social Security Number Social Security Number BANKING Depository Bank for Credit Card Receipts (Visa, American Express, MasterCard) Bank Name Bank Officer Address (Checking) Account No. Balance (Loan) Account No. Balance Phone Terms Requested TRADE REFERENCES: NAME ADDRESS Method of Payment (Check/CC/ACH/Cash) PHONE Spring Water Blvd, Brandonville, PA / (Fax) (Phone) Facsimile or scanned copy will be considered legally binding as original for both pages of this application

2 Signature Springs, LLC AGREEMENT TERMS The undersigned ( Purchaser ) agrees that all purchases made by Purchaser from Signature Springs, LLC or any of its subsidiaries and affiliated entities ( Seller ) are subject to the Terms and Conditions of sale available on the company website, stated on invoices or order confirmations, and by upon request, which may change from time to time, and the following application terms and conditions: All amounts due for goods and services purchased from Seller are payable at the Seller s distribution facility from which the goods and services are delivered. Purchaser acknowledges that such amounts are not payable in installments, but are payable in full as stated herein. All amounts due Seller are payable in accordance with the payment terms granted by Seller s credit department from which the goods and services are delivered. If any amount due Seller is not paid in accordance with such payment terms, a delinquency charge shall be added to the sum due, which charge shall equal the amount obtained by multiplying the delinquent balance by the lesser of (a) two percent (2%) per month or (b) the maximum lawful rate permitted to by charged under applicable state laws. Purchaser shall pay Seller a service charge in amount equal to twenty-five dollars ($25.00) for all checks returned by Purchaser s bank; provided, however, that such service charge shall not be due and payable in the event such payment would result in the violation of the usury laws of the applicable jurisdiction. In the event the account is turned over to an attorney or other agency for collection, or suit is brought on same, or the same is collected through any judicial proceedings whatsoever, Purchaser shall pay all collection costs, attorney s fees and court costs incurred by Seller. Purchaser shall notify Seller by certified mail of any change of ownership of Purchaser. Purchaser warrants to Seller that all financial information furnished for the purpose of obtaining credit is true, correct and complete in all material respects, and Purchaser authorizes Seller to investigate all references furnished pertaining to the credit and financial responsibility of Purchaser. The undersigned purchaser and all guarantors agree that all purchases made from Seller are subject to the terms and conditions set forth in this credit application, on the invoices or on the company website and that there are no oral terms, conditions, or pricing agreements. Undersigned purchaser and guarantors agree that Seller may negotiate any check tendered and apply the proceeds to the outstanding balance owed without regard to any restrictive endorsement purporting to compromise or settle the outstanding balance, said restrictive endorsement being null and void and of no effect. In the event any payment is not made when due, purchaser and guarantors authorize any attorney designated by Seller to appear in any court of competent jurisdiction in Schuylkill County, Pennsylvania, or any other venue where purchaser does business or any guarantors reside, and confess judgment against them for the amount due together with interest, cost of suite, and all attorney s fees, waiving all homestead and other exemptions, relief from stay of execution and right of appeal pursuant to the laws of any State or of the United States now in force or which may hereafter be passed. To the extent practical for Seller and at Seller s sole discretion, Seller is granted a purchase money interest under the Uniform Commercial Code in each item of merchandise purchased on the account, to the extent permitted by law, to secure the purchase price of the merchandise (including collection costs, freight costs and any applicable taxes) until all amounts are paid in full. Type or Print Name of Purchaser Sales Representative of Seller Signature Title Personal Guarantee I/We,, for and in consideration of your extending credit at my request to (the Company ), jointly and severally, personally guarantee prompt payment of any obligation of the Company to Signature Springs, LLC ( Seller ), whether now existing or hereinafter incurred, and I further agree to bind myself to pay on demand any sum which is due by the Company to Seller whenever the Company fails to pay same. It is understood that this guaranty shall be an absolute, continuing and irrevocable guaranty for such indebtedness of the Company. I expressly waive presentment, demand, protest, notice of protest, dishonor, diligence, notice of default or nonpayment, notice of acceptance of this guaranty, notice of the extending of any guarantied indebtedness already or hereafter contracted for by the Company, notice of any modification or renewal of any credit agreement evidencing the indebtedness hereby guarantied, notice of any renewal or extension of such indebtedness, and I expressly consent to any modification or renewal of any credit agreement evidencing the indebtedness hereby guarantied and to all renewals or extensions of such indebtedness. I further waive any right to require Seller to proceed against, or make any effort at collection of the guarantied indebtedness from, the Company or any other party liable for such indebtedness. If the guarantied indebtedness is not paid by me when due, and this guaranty is placed in the hands of an attorney for collection or suit is brought hereon, or it is enforced through any judicial proceeding whatsoever, I shall pay all collection fees, attorney s fees and court costs incurred by Seller. The Guarantor agrees that it shall have no right of subrogation whatsoever with respect to the aforesaid indebtedness or to any money due and unpaid thereon or any collateral securing the same, unless and until all creditors of the obligor shall have received payment in full of all sums at any time due. In the event any payment is not made when due, guarantors authorize any attorney designated by Seller to appear in any court of competent jurisdiction in Schuylkill County, Pennsylvania, or any other venue where purchaser does business or any of the undersigned reside, and confess judgment against them for the amount due together with interest, cost of suit, and all attorney s fees, waiving all homestead and other exemptions, relief from stay of execution and right of appeal pursuant to the laws of any State or the United States now in force or which may hereafter be passed. Should the authorization for confession of judgment be deemed invalid, the remaining provisions of this statement shall remain in full force and effect. In the event more than one party executes this Guaranty as a guarantor, then each guarantor agrees to be jointly and severally liable for the guarantied indebtedness, and in all instances herein, the singular shall be construed to include the plural. I/We further authorize Signature Springs, LLC to obtain a copy of my/our personal credit report. GUARANTOR SIGNATURE (NO CORPORATE TITLES) DATE GUARANTOR SIGNATURE Type or Print Name Type or Print Name Street Street WITNESS Signature WITNESS Signature DATE

3 Last Revised: 05/15/17 Trade Reference Request Form Customer Name: Address: Name & Address of Company/Trade Creditor Providing Reference: Name of person completing form: Title: Fax: Length of relationship with customer: Estimated monthly turnover with customer: Terms of credit: of last sale: Current outstanding balance: Balance past due: High credit: Highest credit in 12 months: Promptness of payment: Always on time (100%) Often on time (50-90%) How would you describe this company as a customer? Excellent Good Signature of person completing this form Fair Nearly always on time (90%+) Rarely on time (<50%) Bad INTERNAL USE ONLY Owner Signature

4 Revised: 05/17/17 New Customer Information Form Company Name: Address: Fax: Artwork Contact: Buyer Contact: A/P Contact: Appointment Req d? Notification Req d? Receiving Contact: Receiving Hours: Dock? Liftgate? Forklift Offload in Parking Lot? Pallet Jack/Forklift Onsite? Lumper Required? If YES Average Cost? Inside Delivery? If YES What Floor? 2nd Floor & Up Elevator? Hand Offload Req d? Note: Inside Delivery permits the carrier to deliver the goods to the immediate entryway of the applicable floor. Customer is responsible for additional transport to the desired location/office. Can a 53 trailer easily turn around in parking lot? Print Name Title Signature

5 Last Revised: 05/15/17 Artwork Mockup Approval Form : Customer: Label: Artwork Contact Name: Your artwork mockup is attached. Please review the mockup and check one of the following options: APPROVED I approve this artwork. I understand this version will be used for production. NOT APPROVED I DO NOT approve this artwork & request the following changes: *If not approved, Signature Springs will adjust the artwork per the above feedback & submit a revised mockup.* Print Name Title Signature Is this artwork for private use or resale? Private Use Resale If private use What state(s) will it primarily be used? If resale What state(s) will it primarily be sold? Do these states have deposit or recycle requirements? No Yes

6 W-9 Form (Rev. December 2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: C Corporation S Corporation Partnership Trust/estate Individual/sole proprietor or single-member LLC Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) a Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) Other (see instructions) a 5 Address (number, street, and apt. or suite no.) Requester s name and address (optional) 6 City, state, and ZIP code 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Social security number or Employer identification number Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person a a General Instructions Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. Form 1099-C (canceled debt) Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. Form 1099-INT (interest earned or paid) 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and Form 1099-DIV (dividends, including those from stocks or mutual funds) Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Form 1099-K (merchant card and third party network transactions) Cat. No X Form W-9 (Rev )