Credit Application

To apply for credit with Access Hardware Supply, please complete the form below and press submit, or print and fax the application to us. Our fax number is (800) 435-8233

Printable Credit Application (requires Acrobat Reader)

Customer Information

Business Name
Address
City State Zip Code

Parent Company (if applies)

Business Name
Address
City State Zip Code

Credit Amount Required Phone Number
$
D & B Number Fax Number
Type of Business

Names of Principles Titles (include chief financial officer)
1.
2.
3.

Financial and Banking Information

Bank Reference
Name
Address
City State Zip

Contact Information Account Type(s)
Name Checking Acct. No.
Telephone Loan Acct. No.
Fax Other Loan Acct. No.

Operating Line of Credit Security to bank
$ $
Loan Paid Monthly
$ $

Acct. Rec. Inventory Personal Guarantee
Other Debenture Personal Guarantee

Commercial and Trade References

Reference 1
Contact Name Contact Title  
 
Address
City, State Zip
Telephone Fax  
 
Reference 2
Contact Name Contact Title  
 
Address
City, State Zip
Telephone Fax  
 
Reference 3
Contact Name Contact Title  
 
Address
City, State Zip
Telephone Fax  
 

Please review this agreement, and check the box to acknowledge and agree the following Terms and conditions:

1. I/We make application to Access Hardware Supply for credit and/or to obtain further credit. l/We certify that the information supplied is true and correct to the best of my/our knowledge and further agree that a facsimile shall be as binding as an original signature.
2. I/We promise to pay the account in full on or before the due date as defined on each invoice. Further, I/we agree to pay any and all late charges assessed at the rate of 18% per annum on past-due balances.
3. Additionally, I/we agree to pay all of the Company's costs and expenses, including but not limited to, attorney's fees and legal expenses, incurred by in collecting amounts owed by applicant, in enforcing any term of this agreement, in responding to defenses, affirmative defenses and/or counterclaims raised by Applicant, and/or in enforcing any term of a related personal guarantee.
4. Venue and jurisdiction of any suit or legal action shall be in jurisdiction of Alameda County, California.
5. I/We agree to notify the Access Hardware Supply in writing prior to any changes in ownership, billing address, or authorized buyers.
6. I/We acknowledge that Access Hardware Supply makes no warranty or guarantee express or implied beyond those stated by the manufacturer. ACCESS HARDWARE SUPPLY DOES NOT WARRANT THE FITNESS OR MERCHANTABILITY OF ANY GOODS. Buyers' remedies for defective or nonconforming goods are limited exclusively to return of the goods and refund of the price or replacement. Access Hardware Supply will not be liable for consequential damages including, but not by the way of limitation, claims for labor and commercial damages.
7. Applicant understands that this credit application in no way obligates Access Hardware Supply to extend credit now or at a future date to the applicant. 10) Applicant is solvent at this time and agrees to notify Access Hardware Supply if Applicant's financial position should change and Applicant is unable to meet its obligations.
8. Access Hardware Supply reserves the right to cancel credit privileges without notice and demand immediate payment of all balances owing and/or withdraw available discounts on purchases if discount or payment terms are not met.
9. This credit application and any rights arising under it may be assigned to another party by Access Hardware Supply at anytime without Applicant's authorization.
10. My/our signature serves as written consent for Access Hardware Supply to access credit information for the purpose of determining my/our credit standing in order to established business credit account.
11. This guarantee shall be governed by and construed in accordance to the laws of the State of California. Access Hardware Supply shall reserve the right to settle any and all disputes or nay breach of this agreement(s) binding arbitration in Access Hardware Supply’s local vicinity. Such arbitration will be conducted by the American Arbitration Association or it’s successor, using a neutral arbitrator and Commercial Rules. Any judgment upon an award rendered by the arbitrator may be entered in nay court having jurisdiction thereof.

THIS AGREEMENT MAY NOT BE MODIFIED OR ALTERED IN ANY MANNER EXCEPT IN WRITING SIGNED BY AN ACCESS HARDWARE SUPPLY CORPORATE REPRESENTATIVE/OFFICER AND APPLICANT/CUSTOMER

Please check this box to affirm that you have read and agree to the terms, conditions and guarantees listed above.

Your Name Title Today's Date
11/21/2008


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14359 Catalina Street • San Leandro, Ca 94577 • (800) 348-2263 phone • (800) 435-8233 fax