Dependable Packaging & Safety Inc.
Accounting 

Office: (909) 851-9111
maira@dependablepkgs.com
www.dependablepkgs.com

NEW ACCOUNT APPLICATION AND CREDIT AGREEMENT
       * FIELDS MARKED WITH AN ASTERISK ARE MANDATORY *

*BILL TO INFORMATION

Company Name: _______________________________________________________________________________

Address: _____________________________________________________________________________________

City: _________________________________________ State: _____________     Zip Code: _________________
_
Tel #:   _____________________________________    Fax #:  ________________________________________

Contact Person: ___________________________________________________________________

*SHIP TO INFORMATION

Address: _____________________________________________________________________________________

City: _________________________________________   State: ______________   Zip Code: ________________

Tel #: ________________________________________    Fax #:  _______________________________________

Contact Person: ____________________________________________________________________

*PRACTICE INFORMATION

Name of Owner/Owners | Title | Social Security #OPTIONAL

Years in Business: _________________________ 

Tax Exempt:	YES       		NO

Tax ID: _______________________________       *Tax Exemption #: ____________________________________
ACCOUNTING AND CREDIT INFORMATION

*Accounts Payable Contact Information:

Name: _____________________________________ Email: ___________________________________________

Telephone #_________________________________ | Fax #_____________________________________________ | | |
Please indicate if your location is a: | | | |
Subsidiary | Division | Branch | Affiliate | Franchise

Name and address of Parent Company: ________________________________________________________

*Trade References:

Name of  Supplier | Contact Person | Phone No.

*Bank References:

*Some institutions require a signature authorizing the release of any information, please sign below *

Name of Bank:  _____________________________________________________________________

City & State:     _____________________________________________________________________

Tel #:   _____________________________________    Fax #:  ________________________________________

Bank Officer: ______________________________________________________________________

Account #:  _______________________________________________________________________

Type of Account:  ___________________________________________________________________

*I authorize,   _____________________________________________,   to release requested bank

                  (Banking Institution Name)

Reference information to Dependable Packaging & Safety INC. Just for the sole purpose of establishing a new account.  (Please make sure this signature is authorized with your banking institution).

We would like to thank you at this time for your interest in doing business with Dependable Packaging & Safety INC. Please allow up to 1 week for the application process. However we aim to process your application within 72 business hours, depending upon how quickly your references respond. If you are in need of the product immediately, please consider a first order onetime credit card purchase. If interested please indicate so on your application.  We accept major credit cards.
To help expedite the process please ensure all areas marked with an asterisk are completed as your application will be deemed incomplete.

CREDIT AGREEMENT

TERMS OF SALE: The standard terms of sale of with Dependable Packaging & Safety INC. (Seller), is NET(    ) Days from the date of the invoice, unless the buyer receives authorization from Seller’s management stating otherwise.

FINANCE CHARGE: A late payment finance charge may be computed at the highest rate permitted by Law, but in no event will it be less than 1.5% per month, or an annual rate of 18% on all amounts remaining unpaid (   )  days after invoice date.

DEDUCTIONS: Allowance shall be made by the Seller for shortages and/or errors conditionally on the Buyer’s written claim for said shortages and/or errors within (     ) days of the date of delivery of the goods giving rise to such claim. Seller shall not be liable for more than the price originally charged for any shortage or error.
RETURNS: The buyer must obtain pre-approved written authorization from the Seller prior to returning merchandise. All returns must comply with the Returned Goods Policy as stated on the back of the current price list.

In consideration of, and in order to induce with Dependable Packaging & Safety INC., to establish a line of credit based of the foregoing application, the company/corporation/individual promises to pay for purchases in accordance with the Seller’s terms of sale. In the event it becomes necessary for the seller to incur collection costs or institute suit to collect any amount due under this credit agreement, or any portion thereof, the company/corporation/individual shall pay all collection costs, charges, and expenses, including reasonable attorney’s fees incurred by the seller in the collection of past due amounts. This agreement and all related business transactions with Dependable Packaging & Safety INC.., shall be governed by the laws of the State of California. In case of any litigation between the parties, the Buyer expressly agrees to accept the exclusive jurisdiction of the courts of California and waives any objection to the exercise of such personal jurisdiction over him or it.

The information and statements in this application are true and complete and are made for the purpose of establishing a line of credit with the Seller. Should any such information or statement, subsequent to their submission to the Seller change or in any way become false, misleading or incomplete, Buyer shall notify Seller in writing. The person executing this Credit Agreement is an authorized representative of the Buyer and is empowered to bind the Buyer to the terms and conditions of this Credit Agreement.

*BUYER: ___________________________________________

*Authorized Signature: _______________________________

*Title:     __________________________________________

*Date:    __________________________________________

Corporate Seal: