Alliance Rental Solutions (Credit-IH)

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Alliance Rental Solutions Alliance Rental Solutions Inc.
26031 Charing Cross Rd.
Valencia, California 91342
Office: (818) 367-6063
Fax: (818) 367-0713

ACCOUNT APPLICATION

The undersigned company is applying for credit with Alliance Rental Solutions Inc. and agrees to abide by the standard terms and conditions of Alliance Rental Solutions Inc. as printed on page 3.

Company Name*

Physical Address*

City*

State*

Zip Code*

Mailing Address

City

State

Zip Code

Phone

Fax

Contact Person*

Email Address for Invoices:

Type of Business

Date Business Established

Contractor's License #

Are you a: (select one)*

CorporationPartnershipProprietorship

State of Incorporation:

Tax I.D. #

Corporate Offiers(s) Names and Titles:

Corporate Officer Name (1)

Title (1)

Corporate Officer Name (2)

Title (2)

Corporate Officer Name (3)

Title (3)

Partner Name (1)

Partner Name (2)

Tax I.D. #

Sole Proprietorship Owner

Address

Social Security No.

Are You Tax Exempt?*

YesNo

(If yes, please provide resale cert) File Upload

Authorized Purchasers

Purchase Order Required*

YesNo

Trade References

Name

Address

Phone

Fax

Name

Address

Phone

Fax

Name

Address

Phone

Fax

Bank References

Account #

Phone

Contact Person

Name of Bank

Address

Account #

Phone

Contact Person

Name of Bank

Address

I represent that the above information is true and is given to induce Alliance Rental Solutions Inc. to extend credit to the applicant. My company and I authorize Alliance Rental Solutions Inc. to make such credit investigation as Alliance Rental Solutions Inc. sees fit, including contacting the above trade references and banks and obtaining credit reports. My company and I authorize all trade references, banks and credit reporting agencies to disclose to Alliance Rental Solutions Inc. any and all information concerning the financial and credit history of my company and myself. I have read the terms and conditions stated on page (3) and agree to all of those terms and conditions.

Authorized Signature*

Printed Name*

Title*

Date*

Date

CONTINUING PERSONAL GUARANTEE (IF A CORPORATION IS APPLYING FOR CREDIT, THIS GUARANTEE MUST BE SIGNED BY A CORPORATE OFFICER)

The undersigned hereby unconditionally guarantees the full and prompt payment to Alliance Rental Solutions Inc. when due all indebtedness, obligations, and liabilities of the customer named in this Credit Application, including all amounts now owing and arising in the future, and including any interest, attorney fees, and collection and court costs. The undersigned agrees to be personally bound by all credit terms and conditions of this Credit Application. This guarantee shall continue in force until notice in writing sent via certified mail, return receipt requested, is received by Alliance Rental Solutions, Inc. This notice shall specify the date of termination, not to be less that seven (7) days after the notice is received and shall not affect any changes for transactions with the customer that were entered prior to the termination date.

GUARANTOR SIGNATURE

PRINT NAME

Date

1. Each invoice is due and payable upon receipt unless agreed otherwise in writing by the parties.

2. If equipment is rented for more than four (4) continuous weeks, periodic invoices will be issued for rental charges due. All such charges are due and payable upon receipt of invoice.

3. A service charge of 2% per month will be added to all amounts billed if not paid by the end of the month.

4. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.

5. Customer shall pay Alliance Rental Solutions Inc. reasonable attorneys fees and collection costs incurred to enforce the terms and conditions of this agreement or collect amounts due hereunder, whether or not a lawsuit is filed.

6. Customer is responsible for any damages to equipment. No damage waiver or insurance is offered, provided or implied by Alliance Rental Solutions Inc.

7. Customer is responsible for theft of equipment. No theft insurance is offered, provided or implied by Alliance Rental Solutions Inc.

I have read and agree to the terms & conditions set forth by Alliance Rental Solutions Inc.

Authorized Signature*

Title*

Printed*

Date*

Date