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Print this form, complete
it by hand, and fax to SES at 630-231-4945.
Or, mail to: SES, Inc., 1400 Powis
Rd., West Chicago, IL 60185
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Company name
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Number of years
in business
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Address
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City, State, Zip
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Telephone
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Brief description
of business
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Insurance carrier or agent
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Brand of equipment
& trucks operated
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Corporation |
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Partnership |
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Individual |
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Name of principal
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Address
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City, State Zip
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Bank
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Address
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City, State, Zip
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| Business References:
We ask that you list only those where you
have had an open account for at least six (6) months. We also
request, if possible, that you list those from whom you have
had equipment repaired. Do not list oil companies or credit
cards, i.e., Sears, MasterCard, American Express |
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1. Name
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Address
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City, State, Zip
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Telephone
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2. Name
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Address
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City, State, Zip
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Telephone
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3. Name
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Address
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City, State, Zip
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Telephone
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4. Name
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Address
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City, State, Zip
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Telephone
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The customer agrees to pay the full amount
of any outstanding balance by the 10th of the month. Customer
agrees to pay a service charge on the outstanding balance
not received by the 10th of the month. The service charge
shall be a minimum of 50 cents or 1 1/2%
per month (18% annum) of the customer's outstanding monthly
balance, whichever is more, after deducting current payments
and credits. Such service charge shall become part of the
customer's outstanding balance.
In the event S.E.S., Inc. must take legal
action to collect this account, customer agrees to pay all
attorney fees, court costs, sheriff's fees and bond costs
incurred by S.E.S., Inc. If any of customer's checks shall
be returned for "insufficient funds" or "account
closed" or "stop payment," customer shall promptly
pay the face amount of the check upon demand. If payment is
not made within five (5) working days after demand, customer
shall pay attorney's fees for collection of the check in addition
to all other payments due and owing.
We expressly recognize that our statements
and promises in the credit application are the consideration
for supplying goods and services by S.E.S., Inc.; further
that we fully understand your credit terms and agree to proper
payment of the account.
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