Ray Anthony International, LLC

Toll Free 1-877-LIFT-THIS
280 N.W. 12th Ave
Pompano Beach, FL 33069
www.rayanthonyintl.com
ONLINE CREDIT APPLICATION

 

In making this application, I/we understand that all accounts, unless otherwise arranged, are payable in accordance with the terms shown on each invoice, and if not paid on or before said date, are then delinquent.

ALL INFORMATION MUST BE COMPLETED - MISSING INFORMATION WILL DELAY PROCESSING OF APPLICATION.

Name of Business:
P.O. Box:
Street Address:
City:
County:
State:
Zip:
Your email:
Type and Nature of Business:
Years in Existence:
Office:
Own Phone:
  Fax:
 
Rent If renting, landlord name:
  Fax:
  Phone Number:

We are:
General Contractor Sub-Contractor Partnership
Sole Owner Sub Sub-Contractor  
Estimated amount of credit needed within a 30 day period ($):
Contractor License No.
Issued by:
Four Trade References and Addresses:
  Firm Entire Address Phone
1
2
3
4

The undersigned hereby authorizes the bank to release information requested by Ray Anthony Intl. in order to obtain a credit account.

Name of Bank:
Address:
City:
Bank Officer:
Account No.
Printed Name of Signature
In lieu of a signature, check here to agree to the terms of conditions of this agreement.
   

Principal Owners of Stockholders and Officers

PRESIDENT/OWNER:
HOME ADDRESS:
CITY:
STATE:
ZIP:
HOME PHONE:
VICE PRESIDENT:
HOME ADDRESS:
CITY:
STATE:
ZIP:
HOME PHONE:

AGREEMENT AND GUARANTEE

1) You (Ray Anthony Intl.) are hereby authorized to check the firm's credit, and company history, through all sources; including, but not limited to credit bureaus, banks, landlords, mortgage holders and accounts in the name of the firm.

2) I/We agree that payment is due 30 days from the date of this invoice.

3) Should I/We default in the payment of any sum, I/We agree to pay interest at the rate of 1 ½ percent per month of the unpaid balance until fully paid. I/We further agree, that if suit is instituted, I/We will pay all collection costs and attorney fees and the venue for any actions regarding this agreement or any purchase from the Seller, will be in Broward County . I/We hereby waive trial by jury in all actions. I/We jointly and severally, hereby, unconditionally, personally guarantee for myself, my agents, and employees the payment of any and all sums that may be charged against this account.

4) In the event that this account is turned over to an outside collection agency, I/We agree to pay collection costs not to exceed 33 1/3 % of amount owed.

5) I/We certify that the above information is true and correct.

Printed Name of Signer Printed Name of Signer

In lieu of a signature, check here to agree to the terms of conditions of this agreement.