Business Information

Company Name*

Address*

Physical Address City State ZIP Code

(d/b/a) Trade Name*

Phone Number*

Fax Number*

Federal Tax ID#*

Company Type:*

Corporation
LLC
Partnership
Proprietorship

Length of Time in Business*

Have you ever filed bankruptcy?*

Banking Information

Bank Name*

Contact Name*

First Last

Phone*

Email Address*

Address*

Street Address City State ZIP Code

Checking Account Number*

Accounting Information

Check if Applicable

Purchase Order Number Required?

Check if Applicable

Tax Exempt?

If checked, attach Tax Exempt Certificate

Tax Exempt Certificate

Max. file size: 50 MB.

Accounts Payable (A/P) Contact*

First Last

A/P Phone Number*

A/P Fax Number*

A/P Email Address*

Trade References 1

Business Name

Address

Street Address City State ZIP Code

Contact Name

First Last

Phone

Email

Trade References 2

Business Name

Address

Street Address City State ZIP Code

Contact Name

First Last

Phone

Email

Trade References 3

Business Name

Address

Street Address City State ZIP Code

Contact Name

First Last

Phone

Email

Credit Application and Agreement

The undersigned (“Customer” or “you”), by signing below, or by ordering any products from Municipal Marking Distributors, Inc. (“MMD”), hereby agrees as follows: (a) all purchases made by Customer from MMD are subject to the terms and conditions contained herein; (b) Customer has read and agrees to all of MMD’s Standard Terms and Conditions of Sale (“Terms and Conditions”), which can be found on our website at https://www.mmdsales.com/terms-conditions/; (c) the Terms and Conditions are hereby incorporated into and made a part of this Agreement and all sales made to Customer; and (d) any terms in Customer’s purchase order or other documentation that are inconsistent with or in addition to this Agreement shall have no force or effect and MMD expressly rejects and does not accept any such inconsistent or additional terms (any use or reference to Customer’s purchase order or purchase order number in any invoice, sales order, acceptance or other documentation is for Customer’s convenience only). You agree to MMD’s terms of payment as follows: All amounts are due and payable Net 30 Days from the date of MMD’s invoice. All amounts payable to MMD which are not paid in full when due shall bear interest at the rate of 1.5% per month until paid in full. You shall pay to MMD all costs and expenses incurred by us in the collection of such amounts, including without limitation, reasonable attorneys’ fees and costs of litigation. All sales are subject to MMD’s return policy, which can be found on MMD’s website (https://www.mmdsales.com/return-policy/), the terms of which are hereby incorporated herein by reference and made a part hereof. No returns will be accepted without prior written authorization. You hereby grant MMD a purchase money security interest in all goods purchased through your account and its proceeds, including insurance proceeds, until MMD has received payment in full for such goods. You authorize MMD to execute and file such UCC financing statements as reasonably required to perfect such purchase money security interest. MMD shall have all the remedies of a seller under the Uniform Commercial Code and any applicable by law. We reserve the right to restrict any transaction to a cash sale. This Agreement and all orders and transactions shall be construed in accordance with the laws of the State of Illinois. You hereby submit to the jurisdiction and venue of the state or federal courts in Kane County, Illinois for any action or proceeding involving this Agreement or any order or transaction hereunder. If any part of this Agreement is held unenforceable, the remainder of this Agreement shall not be affected thereby. Customer waives the right to a jury trial of any or all claims or disputes which may arise from this Agreement or any order. This Agreement may not be amended except in writing signed by both parties. A facsimile or electronic signature shall have the same validity and effect as an original signature. The person executing this Agreement below represents and warrants to MMD that (i) s/he is authorized to do so, and (ii) the information provided in this Agreement is a true and correct statement of the financial condition of Customer. You hereby authorize MMD to make whatever credit inquiries it deems necessary in connection with this Agreement, including contacting trade and banking references, for the purpose of establishing a business line of credit. Bank and trade reference(s) can accept this authorization to disclose to MMD and/or their respective designees (and any assignee or potential assignee thereof), Customer information normally released to a prospective creditor including: length of time account has been active, average monthly balances, how the account has been handled, and details of any lending relationship.

Agriculture

Forestry

Automotive

Industrial

Construction

Surveying

Credit Application

Business Information

Banking Information

Accounting Information

Trade References 1

Trade References 2

Trade References 3

Credit Application and Agreement

Agriculture

Forestry

Automotive

Industrial

Construction

Surveying

Credit Application

Business Information

Banking Information

Accounting Information

Trade References 1

Trade References 2

Trade References 3

Credit Application and Agreement

Order Tracking

Order Information