Facilities Management Credit Application | Whirlwind Clean and Green

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Whirlwind Clean & Green Facilities Credit Application

Company Information

Legal Business Name:  
Line of Credit Requested:  $
D/B/A:  
Federal Tax ID#*:  

Ownership Information

Type of Business*:  
Date Established*:  
Ownership*:  
   

Principle #1

Name:  
Title:  

Principle #2

Name:  
Title:  

Billing Information

Billing Phone:  
Billing Email*:  
Billing Address*:  
Billing City*:  
Billing State*:  
Billing Zip Code*:  
Former Billing Address (if applicable):  
Former Billing City:  
Former Billing State:  
Former Billing Zip Code:  

Trade References

Reference #1

Name:  
Email:  
Phone #:  
Fax #:  

Reference #2

Name:  
Email:  
Phone #:  
Fax #:  

Reference #3

Name:  
Email:  
Phone #:  
Fax #:  

Reference #4

Name:  
Email:  
Phone #:  
Fax #:  

Bank References

Bank Reference #1

Bank Name:  
Contact Name:  
Email:  
Phone #:  
Address:  
City:  
State:  
Zip:  

Bank Reference #2

Bank Name:  
Contact Name:  
Email:  
Phone #:  
Address:  
City:  
State:  
Zip:  
 
Has the firm or any of its principles ever been bankrupt?:  
 
If yes, please explain:  


Any misrepresentation in this application will be considered evidence of fraud, since this information is the basis for the extending of credit. As an inducement to grant credit, the undersigned warrants that the information submitted is true and correct. You are authorized to investigate the credit references and principles listed.

In consideration for the extension of credit, said business promises to pay for all purchases within the terms agreed Net 30 and agrees to pay a service charge per month of 1-1/2% per month (18% annual percentage rate) on all past due balances. In the event any third parties are employed to collect any outstanding monies owed by said business the undersigned agrees to pay reasonable collection costs, including attorney fees, whether litigation has commenced, and all costs of litigation incurred. The undersigned represents that he/she has the authority to execute this credit agreement on behalf of the business identified.

It is understood and agreed that credit, if extended, is to be on a continuing basis and may exceed estimated maximum credit limit required as stated in the credit agreement between Whirlwind Clean and Green and the business. Whirlwind Clean and Green shall not be obligated to notify the undersigned of the dates or amounts of any such credit and the undersigned waives demand, notice of default and any extension of time or any other forbearance which may be extended by Whirlwind Clean and Green.

Signed By:
Title: