Thank you for your interest in becoming a customer of Cheney Brothers, Inc.

Similar documents
CHENEY BROTHERS, INC. NEW ACCOUNT / CREDIT APPLICATION FORM

Welcome to Ariola Imports Miami!

*** N E W O P E N A C C O U N T A P P L I C A T I O N * * *

TO: ATTN: FAX: DATE: Credit Application. Thank you for your interest in obtaining an open account with Culverts, Inc.

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

Co-Applicant. Phone. Fax. Business Information

Royal Group, Inc. or Royal Plastics Group USA Group Company name CREDIT APPLICATION

PLEASE. To Process your Application we must have the following:

APPLICATION FOR BUSINESS CREDIT

*SLA LICENSE SERIAL #: *NY STATE TAX ID #:

CREDIT APPLICATION. Billing Address City: State: Zip: Shipping Address City: State: Zip: DBA: Established:

Credit Application Commercial VISA

Credit Application Fax to: to:

CARRIER ENTERPRISE NORTHEAST, LLC ( CE ) (PLEASE PRINT CLEARLY) Credit Agreement

(This Agreement supersedes all prior Agreements) AGREEMENT

CUSTOMER CREDIT APPLICATION

Welcome to Monoprice, Inc.

Business Account Application

SUMMARY. February 1, 2011

Name of Individual or Legal Entity Responsible for Payment. City State Zip City State Zip. Phone Number Fax Number Phone Number Fax Number

JOINT ACCOUNT. Last Name: First Name: Initial: Date of Birth: Street Address: City, State, Zip: County:

Small Business Credit Card New Business Credit Card Account Relationship

Organization Account Application

GRAND RAPIDS CRANE CO LLC.

VISA CORPORATE CARD APPLICATION

Purpose (use of funds) Collateral: Unsecured Real Estate Vehicle Accounts Receivable Inventory Equipment Deposits/Securities Other (Describe)

Customer Application Cover Page. Customer Name:

Individual Retirement Account (IRA) Application Type of IRA

Mailing Address: City: State: Zip: (If different than above) Name: SS#: DOB: Printed Name: Title:

SUBSCRIPTION AGREEMENT

FILED: NEW YORK COUNTY CLERK 08/14/ :36 PM INDEX NO /2015 NYSCEF DOC. NO. 22 RECEIVED NYSCEF: 08/14/2015. Exhibit C

Customer Account Information Form Please fill up clearly in BLOCK LETTERS.

Deising s Bakery and Restaurant North Front Street Kingston, New York Tel: Fax:

BECK EQUIPMENT, INC Preble Rd, Preble, NY Toll Free: (866) / Fax: (607)

Investment Advisor Firm (Agent) and Primary Contact: Firm Name: Primary Contact: Title of Trust:* Effective Date of Trust: Trust Tax ID Number:

TERMS AND CONDITIONS REGARDING SERVICES RENDERED BY INTERNATIONAL WAREHOUSE SERVICES, INC.

VISA BUSINESS CREDIT CARD APPLICATION

Alaska Ship Supply Dutch Harbor / Captains Bay A division of Western Pioneer, Inc.

C O M M E R C I A L C R E D I T A P P L I C A T I O N

GLOBAL PC DIRECT, INC Fremont Blvd, Fremont, CA Tel: (510) Fax: (510)

CREDIT APPLICATION / APPLICANT AGREEMENT

Welcome to the DT Global, Inc family. Establishing open terms will allow the most efficient method of product purchase and delivery.

Fax the documents listed below to to start today!

«f80» «f81» «f82», «f83» LENDER SERVICING AGREEMENT

CREDIT APPLICATION & AGREEMENT. Applicant's legal name: City: State: Zip: City: State Zip. Federal ID Number: Social Security #

SUBSCRIPTION AGREEMENT AND POWER OF ATTORNEY Of DLP LENDING FUND, LLC

Account Manager: Legal Name of Firm. DBA Name of Parent Company (If subsidiary) Street: Business Mailing Address. Street: Business Shipping Address

commercial credit application

APPLICATION INSTRUCTIONS

Health Savings Account Application

Matrix Trust Company AUTOMATIC ROLLOVER INDIVIDUAL RETIREMENT ACCOUNT SERVICE AGREEMENT PLAN-RELATED PARTIES

SUBSCRIPTION AGREEMENT AND ACCREDITED INVESTOR QUESTIONNAIRE for COMMON STOCK

Benbid.com Inc. Private Placement Subscription Agreement A

INTERCOMPANY SUBORDINATION AGREEMENT

Mango Bay Properties & Investments dba Mango Bay Mortgage

Application for License, Permit and Miscellaneous Bonds BOND INFORMATION

John Deere Construction Phone: Fax:

Capitol-Husting Company, Inc. /Allstate Liquor & Wine Co.

Georgia National Guard Service Cancelable Loan

General Instructions For Completing This Joinder Agreement

LYNCH OIL COMPANY, INC. Toll Free (800) P.O. BOX Fax (407) KISSIMMEE, FLORIDA

Commercial Credit Application

CREDIT APPLICATION. On behalf of Lodge Lumber Company, Inc., I would like to thank you for your interest in doing business with our company.

Investment Advisor Firm (Agent) and Primary Contact: Firm Name: Primary Contact:

Thank you for your interest in becoming a customer of Southern Glazer's Wine & Spirits of Nevada

MARGIN AGREEMENT. KEEP A COPY FOR YOUR RECORDS. This is a copy of your Margin Agreement with Pershing LLC ( Pershing ).

Standard Credit Package Attn: Brenda Koch Ph.:

FILED: NEW YORK COUNTY CLERK 04/22/ :31 PM INDEX NO /2016 NYSCEF DOC. NO. 25 RECEIVED NYSCEF: 04/22/2016

FAIRFAX PHARMACEUTICAL WHOLESALER INC NEW CUSTOMER APPLICATION

SECTION I. Appointment, Activities, Authority and Status of REPRESENTATIVE

Teleflex Medical / Arrow International / Arrow Cardiac Care New Account Application Checklist **PLEASE READ**

CHURCH/MINISTRY/BUSINESS ACCOUNT CHECKLIST

BUSINESS REWARDS CREDIT CARD AGREEMENT (TO BE USED FOR CORPORATIONS, PARTNERSHIPS, LLCs, SERVICE ORGANIZATIONS OR OTHER BUSINESSES)

Farmers State Bank of Calhan Visa Business Credit Card Application

Kansas Credit Services Organization Instructions for Application of Registration

PRIMARY OWNER INFORMATION

REVOLVING LINE OF CREDIT NOTE. $30,000, Los Angeles, California December 15, 2007

PROMISSORY NOTE. CITY OF AZUSA, or the holder of this Note. Five percent (5.00%) per annum above the Prime Rate.

FIXED RATE PROMISSORY NOTE (INTEREST-ONLY PAYMENTS)

Credit Application & Insurance requirements

QuickLink Credit Application and Account Agreement

* Corporation General Partnership Limited Partnership LLC Sole Proprietorship Non Profit Other Accounts Payable: Name

3776 S.R. 93 N.E., Crooksville, OH Toll Free (866) * Phone (740) * Fax (740)

CADA DEALER BOND INSTRUCTIONS

LETTER OF CREDIT AGREEMENT

, Note (the Note ) made by Borrower in the amount of the Loan payable to the order of Lender.

COMMERCIAL HARDWARE 3725 W. RUSSELL RD. LAS VEGAS, NV (702) PHONE (702) FAX

Thank you! Anne Ball Barngrover Glass Accounts Receivable Office ext 12

Samson Information Technologies (Pvt) Ltd

INDIVIDUAL 401(k) RECORDKEEPING SERVICE AGREEMENT

Unit Corporation (Exact name of registrant as specified in its charter)

AUTHORIZED DEALER REQUIREMENTS

Apollo Medical Holdings, Inc.

MEMORY BANK ACCOUNT RULES (continued)

TIP 95A01-28 Date Issued: Sep 28, 1995 EXEMPTION EXTENDED FOR LARGE BOATS SOLD TO NONRESIDENTS

FLORIDA CREDIT UNION

U.S. REVOLVER COMMITMENT INCREASE SUPPLEMENT

PLEASE. To Process your Application we must have the following:

LOAN AGREEMENT R E C I T A L S

REVOLUTION LIGHTING TECHNOLOGIES, INC. (Exact name of registrant as specified in its charter)

Transcription:

Delivering Southern Hospitality Since 1925 www.cheneybrothers.com Thank you for your interest in becoming a customer of Cheney Brothers, Inc. The following pages are for opening an account, information for payment, and instructions on how to obtain credit terms at Cheney Brothers. Please find the following: - New account application form - Florida Department of Revenue form - Wire instructions for payment - Letter of Credit instructions In order to purchase from Cheney Brothers, a new account form must be filled out completely, including but not limited to: - Complete Legal and trade name and address, phone, and email. - Owner, Director, or Management name, home address, home phone, date of birth, Social Security ( US residence ), and copy of passport. - Name and signature of person submitting the passport after PAYMENT TERMS. - The Florida Department of Revenue must be signed to avoid Sales tax If customer is requesting credit terms, credit terms will be considered upon receipt of the following: - In order to receive credit terms, the personal guarantee must be signed by person submitting the passport in the new account application form. - Credit terms will be given upon receipt of Letter of Credit from Bank for the amount of credit desired. Letter of Credit must come from a qualified bank and worded with instructions as shown in the Letter of Credit Instructions. - Credit terms will be considered upon receipt of a copy of three invoices from different suppliers within the United States from the last 60 days, showing the credit terms received and the total amount of the invoice. Thank you for the opportunity to be of service to your company. Gene Allison Cheney Brothers, Inc. Vice President International Sales One Cheney Way, Riviera Beach, FL 33404 7000 561.845.4700 office 800.432.1341 toll free 561.845.4701 fax 2801 W. Silver Springs Blvd, Ocala, FL 34475 5655 352.291.7800 office 800.939.4018 toll free 352.291.7878 fax

ONE CHENEY WAY RIVIERA BEACH, FL USA 33404-7000 W.P.B. 561-845-4700 WATS 800-432-1341 Legal Business Name CHENEY BROTHERS, INC. NEW ACCOUNT / CREDIT APPLICATION FORM FOR INTERNATIONAL SALES ACCOUNTS ONLY * incomplete application may not be processed Trade Name (d/b/a) Direct Contact: Gene Allison Phone: (561)845-4718 (561)684-7993 Email:genea@cheneybrothers.com Address Street City State Country Zip Phone No (including country Fax No (including country code ( ) ( ) Email address BUSINESS FACTS Proprietorship Corporation Partnership Limited Liability Company Other Length of time in business ACCOUNTING INFORMATION Accounts Payable Contact At present location Phone No. (include country code OWNERSHIP Complete the following information for two corporate officers, partners, or an individual proprietor (add additional sheets if necessary) Name and Title Name and Title Home Address Home Address City /State/Country/Zip City /State/Country/Zip Home Phone (include country Business Phone (include country Home Phone (include country Business Phone (include country Passport Number Date of Birth Passport Number Date of Birth BANKING 1. Name 2. Name Address (including City, State and Country) Account # Account # Phone # (including country Person to Contact Years with Bank Address (including City, State and Country) Phone # (including county Person to Contact Years with Bank TRADE REFERENCES (Preferably Food Distributors and preferably in United States) 1. Name 3. Name Phone # (including country 2. Name 4. Name Phone # (including country Phone # (including country Phone # (including country Please attach an invoice for a transaction in last sixty (60) days for each trade reference. TERMS AND CONDITIONS Parties hereby agree that all purchases made are subject to the following terms and conditions: 1. The undersigned Purchaser hereby agrees that all amounts due for goods and services purchased from Cheney Bros., Inc. d/b/a Cheney Brothers, Inc. ( Cheney Brothers ) are payable at the address shown on the invoice and statement. In the event of any change in Purchaser name, location, authorized agents, or ownership, Cheney Brothers must be notified in writing. Any change may require a new New Account and Credit Application. Failure to do so will result in prior owners remaining jointly and severally liable for any new ownership or unauthorized debts. Purchaser and Guarantor agree to supplement credit information upon request. 2. If any amount due Cheney Brothers is not paid in accordance with the credit terms extended by Cheney Brothers, a delinquency charge in the amount of 1 1/2% per month, or any higher amount as permitted by Florida law, on the unpaid balance, shall be

CHENEY BROTHERS, INC. NEW ACCOUNT / CREDIT APPLICATION FORM FOR INTERNATIONAL SALES ACCOUNTS ONLY added to the total amount due. Additionally, any attorneys fees and costs, including but not limited to costs and fees of in-house counsel or outside counsel, incurred in connection with efforts to collect any sums due, shall be added to the total amount due. Any attorneys fees and costs shall include costs and attorneys fees pre-litigation, at the trial level, on appeal, or in any bankruptcy or other proceeding. Purchaser agrees and acknowledges that any delay by Cheney Brothers in demanding payment or its acceptance of any partial payment shall not be deemed a waiver of any of Cheney Brothers rights. Venue for all actions arising out of or relating to this credit application or the transactions contemplated herein shall be exclusively in Palm Beach County, Florida or such other venue chosen by Cheney Brothers, in its sole and absolute discretion. All transactions and agreements between the parties shall be governed by and interpreted in accordance with the laws of the State of Florida without regard to conflicts of law. Purchaser and Guarantor submit to personal jurisdiction in the State of Florida with respect to any and all matters arising out of or relating to this application and any dealings with Cheney Brothers. Purchaser and Guarantors further agrees that valid service of process or any other papers may be effected on them via mail or through service on the Florida Secretary of State. 3. The undersigned Purchaser agrees, pursuant to Florida Statute, Section 68.065, to pay Cheney Brothers the greater of (a) 5% of the face value of the check or other payment instrument which is protested, returned, deemed worthless, or otherwise dishonored due to a lack of funds, lack of credit, lack of an account, or which is stopped; or (b) the service charges specified in Florida Statute, Section 68.065 (2). Additionally, Purchaser agrees to pay the above sum(s) plus three (3) times the amount of the face value of such check or payment instrument along with any court or other costs and reasonable attorneys fees, including but not limited to in-house attorneys fees, in any action or efforts to recover the sums set forth herein. 4. In the event that a guarantee is executed, then all so executing shall be jointly and severally liable with each other and the Purchaser and relevant words herein shall be read as if referring to both the Purchaser and the Guarantor(s) in the plural. 5. The parties hereby acknowledge that the goods and/or services purchased from Cheney Brothers are not payable in installments, but are payable in full as stated herein. Ownership of the goods and services does not transfer to Purchaser until paid in full, unless otherwise stated. At any time prior thereto, Cheney Brothers reserves the right to confiscate such goods or cease such services in the event Purchaser fails to meet its payment obligations. Unless otherwise agreed in writing, any products or equipment leased or loaned to Purchaser must be returned within seventy-two (72) hours or Purchaser will be billed for cost of same at the full retail price of said products or equipment. Purchaser acknowledges that the goods and products purchased from Cheney Brothers may be subject to the Perishable Agricultural Commodities Act and that Cheney Brothers shall be entitled to all rights associated therewith, including, without limitation, status as a priority creditor in any relevant proceeding. 6. The undersigned Purchaser and Guarantor(s) hereby authorize(s) you to verify the information on this form, which is being requested by Cheney Brothers to establish credit with it. Specific Authorization is given to both the bank and trade references listed to disclose all account information for the specified accounts. Cheney Brothers is further authorized to conduct a credit check through Equifax or other credit-reporting agency on the Purchaser, Guarantor(s) and each individual officer, owners, partner or proprietor identified herein. Each such individual/party agrees to submit a copy of his/her driver s license, passport, or photo ID and any other identifying information requested as identification for this purpose. This form may be transmitted to any of the parties noted as proof of authorization. Cheney Brothers does not guarantee that Purchaser will be granted any terms of credit. Granting and the continued extension of credit terms, if any, is solely in Cheney Brothers discretion. 7. If purchase or payment is permitted to be made by credit card (requires separate authorization and form), Purchaser/cardholder waives all right to dispute or protest any and all such charges with its credit card company or bank. Charges, once made, are final and may only be disputed directly with Cheney Brothers. 8. Unless otherwise agreed in writing, upon closure of account, payment of all outstanding balances is due within seventy-two (72) hours. 9. Cheney Brothers may assign any and all of its rights and obligations herein to its affiliates as well as its successors and assigns. Purchaser may not assign any of its rights or obligations hereunder without written consent of Cheney Brothers. PAYMENT TERMS The undersigned hereby agrees that payment terms are as specified on invoice unless otherwise agreed by the parties and memorialized in writing. Date Sales Representative (Signature) Number X Officer, Owner or Partner (Signature) Sales Manager (Signature) Type or Print Name Title INDIVIDUAL PERSONAL GUARANTEE REQUIRED FOR CREDIT TERMS I, (type or print name), residing at for and in consideration of your extending credit at my request to (Name of Company/ purchaser ) of which I am hereby personally guarantee to Cheney Brothers Inc. payment of any obligation of the purchaser and I hereby agree to bind myself to pay on demand any sum which may become due to Cheney Brothers Inc., by the purchaser whenever the purchaser shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable indemnity for such indebtedness of the purchaser. I do hereby waive notice of default, non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guaranteed and to all renewals of extension of credit. This guarantee extends to all obligations of purchaser, including but not limited to, purchaser s obligation to pay service charges and potentially treble damages, attorneys fees and costs associated with any collection activities (either by referral to collection company or attorney). GUARANTOR S SIGNATURE DATE WITNESS SIGNATURE DATE (Revised 2018)

NONRESIDENT DEALER STATEMENT Pursuant to 212.06(5)(b)1., Florida Statutes Selling Dealer s Name: Cheney Bros., Inc. d/b/a Cheney Brothers, Inc. Selling Dealer s Address: One Cheney Way, Riviera Beach, Florida 33404 Nonresident Dealer s Name: Nonresident Dealer s Address: Nonresident Home State Sales Tax Number: (Please Print Name) (Please Print Name) Passport or Visa Number: 1 Arrival-Departure Card Number: 2 Nonresident Dealer s Evidence of Authority to do Business in Home State: 3 (i.e. Occupational license number) I certify that (a) I am authorized to execute this statement on behalf of the Nonresident Dealer identified above (the Nonresident Dealer ); (b) all of the information referenced above is true and correct; (c) that the Nonresident Dealer does not hold a Florida sales tax registration; and (d) that all of the tangible personal property (including all materials, merchandise, equipment, and/or goods) purchased from Cheney Bros., Inc. d/b/a Cheney Brothers, Inc. by Nonresident Dealer will be transported outside of the State of Florida by the Nonresident Dealer for resale and for no other purpose. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true to the best of my knowledge and belief. Acknowledged and Agreed: (Print Nonresident Dealer/Customer Name) (Signature) By: Its: (Name of signatory) (Title of signatory) Date: 1 For nonresident dealers who are not residents of the United States. 2 For nonresident dealers who are not residents of the United States. 3 Pursuant to 212.06(5)(b)1., all nonresident dealers must provide Cheney Brothers, Inc. with evidence of authority to do business in the nonresident dealer s home state or country, such as his or her business name and address, occupational license number, if applicable, or any other suitable requirement.

Delivering Southern Hospitality Since 1925 www.cheneybrothers.com WIRE INSTRUCTIONS FOR CHENEY BROTHERS Wells Fargo Bank 420 Montgomery St. San Francisco, CA 94104 Phone: 1 800 522 4045 ABA# 121000248 Swift Code: WFBIUS6S Beneficiary: Wells Fargo Bank Account# 2687905807046 For further credit to: Cheney Brothers, Inc. One Cheney Way Riviera Beach, Fl. 33404 One Cheney Way, Riviera Beach, FL 33404 7000 561.845.4700 office 800.432.1341 toll free 561.845.4701 fax 2801 W. Silver Springs Blvd, Ocala, FL 34475 5655 352.291.7800 office 800.939.4018 toll free 352.291.7878 fax

Delivering Southern Hospitality Since 1925 www.cheneybrothers.com LETTER OF CREDITS For those customers that want credit, then the customer can get credit terms by offering security in the form of a letter of credit from a bank. Then we will give them credit terms. If they pay according to the credit terms, then we will not use or execute on the letter of credit. However if they do not pay according to the terms they were given, then we will file a claim against the letter of credit to get paid. Below is an example of the wording that we require. The following information must be submitted from the applicant to his issuing bank. IRREVOCABLE STAND BY LETTER OF CREDIT AMOUNT: $$$$$$$$$$ BENEFICIARY: CHENEY BROTHERS, INC ONE CHENEY WAY RIVIERA BEACH, FL 33404 WIRE TRANSFER: Wells Fargo Bank 12 East 49 Street MCJ0109-431 New York, NY 10017 ACCOUNT NUMBER 2687905807046 ABA NUMBER 121000248 SWIFT CODE: WFBIUS6S FIN NUMBER: 591003104 DOCUMENTS TO BE PRESENTED: COPY(S) OF UNPAID INVOICE (S) NOT PAID WITHIN 60 DAYS FROM DATE OF INVOICE One Cheney Way, Riviera Beach, FL 33404 7000 561.845.4700 office 800.432.1341 toll free 561.845.4701 fax 2801 W. Silver Springs Blvd, Ocala, FL 34475 5655 352.291.7800 office 800.939.4018 toll free 352.291.7878 fax