QUALITY
EQUIPMENT RENTALS
U-Cart Concrete TO-GO
711 N. La Brea Ave.
Inglewood, CA 90302-2203
800/300-RENT (7368), 310/677-7600, FAX: 310/677-7857
CREDIT AGREEMENT
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Customer/Company
Name____________________________________________________Date_________/_________/________
Mailing Address_________________________________________________________________________________________
City_____________________________________________________________State_______________Zip________-________
Real Address____________________________________________________________________________________________
Office Phone #__________________________Fax__________________________JobPhone
#___________________________
Corporation: Yes____ No___Federal ID #_________________________Contractor's
License #____________________________
Person's Name Requesting Account (Please Print)_______________________________________________________________
Business Owner's Name (Please Print)____________________________SS #________________________________________
Type of Business_____________________________________How Long in Business(Yrs.)_____________________________
AMOUNT OF CREDIT REQUESTED____________________________________________________
Circle if You Require Any of the Following: Purchase
Order Numbers Job
Numbers Job
Address
Bank Name_______________________________________________________Account#_______________________________
Branch_________________________________________________________Phone#__________________________________
Adress_______________________________________City________________________State________Zip________________
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| How Did You Find Out About Our Company?______________________________________ |
References (Open
Charge Accounts Only, No Credit Cards) |
Please Do Not Write In This Area, This Side |
Name_____________________________________________
Address__________________________________________
City______________State_______Zip___________
Phone #____________________ Fax #____________________ |
Account Opened______________________________________
High Credit_________________________________________
Terms______________________Pay____________________
|
Name_____________________________________________
Address__________________________________________
City______________State_______Zip___________
Phone #____________________ Fax #____________________ |
Account Opened______________________________________
High Credit_________________________________________
Terms______________________Pay____________________
|
Name_____________________________________________
Address__________________________________________
City______________State_______Zip___________
Phone #___________________ Fax #_____________________ |
Account Opened______________________________________
High Credit_________________________________________
Terms______________________Pay____________________
|
