Crane Rental Application for Credit

CRANE RENTAL APPLICATION FOR CREDIT

Information provided by the undersigned will be held in strict confidence and will be used solely by Crane Rental for the purpose of extending credit.

LEGAL NAME OF APPLICANT: ______

Trade Name: (if any): ______

Physical Address: ______

City: ______County: ______State: ______Zip/Postal Code: ______

Phone #: ______Fax #: ______E-Mail: ______

Would you like your invoices provided by mail, email, or both? Mail: _____ Email: _____ Both: _____

Business Type: Incorporated ____ Propietorship ___ LLC ___ LLP ___ Not-for-Profit ___ Municipality ___

Purchase Order Required: Yes _____ No _____

Date Business Established: ______Date of Incorporation: ______

State of Incorporation: ______Federal I.D. Number: ______

PRINCIPAL OWNERS, OFFICERS AND PARTNERS: (Attach separate sheet with additional information if necessary)

Name: ______Title: ______

Home Address: ______

CREDIT REFERENCES: [ ___ ] Check here if Trade Reference Letter is attached.

Trade Reference: Name: ______Phone: (____) ______Fax: (____) ______

BANK REFERENCES:

Name: ______Phone (_____) ______Fax: (_____) ______

CRANE RENTAL APPLICATION FOR CREDIT

Applicant certifies that all information contained herein is true and correct. Applicant grants permission to Crane Rental to obtain independent credit reports or credit reports and other information from its references and bank, and authorizes the credit references and bank reference(s) to release information to Crane Rental that may be used to determine credit worthiness. Applicant agrees to pay all bills rendered.

Our standard Credit terms are payment in full within 30 days of invoice date. Any past due account is subject to being placed on C.O.D. until paid in full. Repeated late payments could possibly result in rental privileges being revoked. Applicant acknowledges and agrees to pay a service charge of no more than 2.0% per month that can be charged on balances not paid within terms.

Applicant agrees to pay all costs of collections, including actual out-of-pocket expenses and a collection fee of thirty-three percent (33%) if collected through a collection agency or attorney. The laws of the State of Kansas shall govern all contracts entered into between Applicant and Crane Rental, and all disputes may be resolved within the Courts within the State of Kansas.

Date: ______Company: ______

Signature: ______Printed Name: ______

Title: ______

WHEN COMPLETED, PLEASE SEND TO: , OR FAX TO (785) 827-4881.

A VALID STATE RESALE/EXEMPT TAX CERTIFICATE FORM MUST BE ATTACHED FOR TAX EXEMPTION STATUS.

PERSONAL GUARANTEE:

To induce Crane Rental to extend credit to the above Applicant, the undersigned (“Guarantor”), an owner of applicant, hereby guarantees payment when due of all accounts, including service charges, payable by Applicant to Crane Rental. Any revocation of charge privileges shall not affect the guaranty with respect to amounts owed before receipt of the Notice of Revocation by Crane Rental. Notices of acceptance, default and nonpayment are hereby waived. This guaranty shall be a continuing and irrevocable guaranty and indemnity for indebtedness of Applicant to Crane Rental. Guarantor, without notice, consents to any modification, extension and/or renewal of the credit agreement hereby guaranteed. If the Applicant fails to pay the account when due, Crane Rental may proceed hereunder against Guarantor without notice and without first proceeding against Applicant to exercise all legal remedies available to collect the balance due.

Guarantor’s Name (Please Print): ______

Guarantor’s Signature: ______

PERSONAL GUARANTEE: (Corporations, Partnership and LLC’s)

If applicant is a corporation, LLC, partnership, or other artificial entity, the undersigned person hereby personally and unconditionally guarantees punctual payment by customer as required by this Agreement. Any revocation of charge privileges shall not affect the guaranty with respect to amounts owed before receipt of the Notice of Revocation by Crane Rental. Notices of acceptance, default and nonpayment are hereby waived. This guaranty shall be a continuing and irrevocable guaranty and indemnity for indebtedness of Applicant to Crane Rental. Guarantor, without notice, consents to any modifications, extension and/or renewal of the credit agreement hereby guaranteed. If the Applicant fails to pay the account when due, Crane Rental may proceed hereunder against Guarantor without notice and without first proceeding against Applicant to exercise all legal remedies available to collect the balance due.

Guarantor’s Name (Please Print): ______

Guarantor’s Signature: ______