Southern Welders Supply

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CREDIT APPLICATION

Email *

NAME OF BUSINESS OR INDIVIDUAL *

Phone Number

Valid Email *

PHYSICAL ADDRESS *

Street Address, City, State, Zip code

BILLING ADDRESS *

Street Address, City, State, Zip code

COMPANY OFFICERS OR PARTNERS *

ACCOUNTS PAYABLE CONTACT *

Name, email address and phone number

Would you like to enroll in paperless billing?

Statements and invoices will be emailed to the above email address.

Yes

BANKING INFORMATION *

PLEASE LIST * 3 CREDIT REFERENCES MINIMUM

(vendors with at least a 30 day Net) not applicable for COD / restaurant accounts.

Vendor, contact name, contact phone number and contact email

COMPANY TAX INFORMATION *

If your company is SC Tax exempt, please provide your SC tax exemption number. If the items you are purchasing are intended for resale please provide us a copy of your SC Resale Certificate form ST-8A sent to dawndingman@swelders.com.

WHAT TYPE OF CREDIT ARE YOU SEEKING? *

CHARGE ACCOUNT FOR HARD GOODS

CHARGE ACCOUNT FOR CYLINDER RENT/LEASE AND GAS

NO CHARGE ACCOUNT, JUST WANT TO RENT OR LEASE CYLINDERS

DOES YOUR COMPANY REQUIRE PURCHASE ORDERS *

YES

TERMS AND CONDITIONS OF SALES

Charge Sales: Seller agrees to abide by the terms set by Southern Welders Supply Company, Inc.

Mechanic's Lien: Buyer agrees that he has not and will not do anything, directly or indirectly, which has or will have, the effect of releasing, waiving, or surrendering the mechanic's lien rights of the seller. Upon demand by the seller, buyer shall be obligated to furnish seller with all information needed for seller to obtain a mechanic's lien, if this becomes necessary. Buyer agrees to pay all court costs, recording fees, reasonable attorney fees, and other expenses incurred by seller in securing seller's mechanic's lien rights in the event of default by the buyer.

Delivery: All materials when delivered shall become the sole responsibility of the buyer and all risk of loss shall be transferred to the buyer.

Returns: Unless due to sellers error, no materials shall be returned, or credit allowed without seller's prior authorization. Materials returned in good condition may be credited at invoice price less 15% to cover handling, service charges, and expenses. All returns for credit or must be accompanied by a receipt. Special ordered, non-stock merchandise may not be returned.

I/We apply for credit and will abide by the terms and conditions of Southern Welders Supply Company. I understand, acknowledge, and accept these terms of sales. I also acknowledge that all of the information contained in this application is true and correct.

I acknowledge

GUARANTEE AGREEMENT

(Must be filled out for Businesses/Corporate Accounts with less than ONE year of Credit References)

The undersigned guarantees payment of all indebtedness by the above applicant to Southern Welders Supply Company, whether now due or hereafter incurred. This payment will be made in South Carolina at the offices of Southern Welders Supply Company. The undersigned also agrees to pay to Southern Welders Supply Company reasonable attorney fees and collection company costs in the collection of such indebtedness. It shall not be necessary for Southern Welders Supply Company, in order to enforce the obligation of the undersigned hereunder, to first institute suit or pursue or exhaust its remedies against applicant. If more than one individual signs below, each shall be liable hereunder jointly and severally. The guarantee shall remain in full force and effect until released by Southern Welders Supply Company in writing or until notice is received by Southern Welders Supply Company from the undersigned, although such notice by the undersigned shall apply only to indebtedness arising thereafter and shall not affect the guarantee of indebtedness then existing. Please note that a signature, followed by a corporate title, invalidates the personal guarantee. Please initial below:

Building/Property Owner (if not owned by company applying for credit):

Contact name, phone number and email

Credit Card must be listed below for all No Credit References (COD accounts), Individuals and Restaurants

NAME ,NUMBER, EXPIRATION DATE, CCV, BILLING ZIP CODE. Your COD account will not be validated without this information.

A copy of your responses will be emailed to the address you provided.

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