Price On-Site — On Site Credit Application — Hydraulic Repair Wisconsin, Fluid Power, Wind Turbine Repair, Testing and Service

Credit Application

For the purchase of hydraulic, pneumatic, electrical and engineered products from Price On-Site.

Company Name: required
Applicant First Name: required
Applicant Last Name: required
Applicant Email: required

Billing Address

PO Box/Street Address: required
Address Line 2:
City: required
State: required
ZIP: required

Shipping Address (if different)

PO Box/Street Address:
Address Line 2:
City:
State:
ZIP:

Company Profile

Phone: required
FAX: required
Years in Business: required
Annual Sales: required
Number of employees: required
D & B #: required
SIC/NAIC #: required
Affiliated Companies:
Your Company's Products/Services: required
Tax Exempt?: required
- Yes
- No
If tax exempt, please fax your tax exempt certificate to 262-369-3715 or scan & email to accounting@priceeng.com

Company Officers

First Name: required
Last Name: required
Title: required

First Name:
Last Name:
Title:

Accounts Payable Contact

First Name: required
Last Name: required
Email: required
FAX: required

Purchasing Contact

First Name: required
Last Name: required
Email: required
FAX: required

References

- Company: required
- Address Line 1: required
- Address Line 2:
- Phone: required
- Fax: required
- Company: required
- Address Line 1: required
- Address Line 2:
- Phone: required
- Fax: required
- Company:
- Address Line 1: required
- Address Line 2:
- Phone: required
- Fax: required
- Bank: required
- Address Line 1: required
- Address Line 2:
- Phone: required
- Fax: required

Terms and Conditions

CONFIRMATION OF INFORMATION ACCURACY AND RELEASE OF AUTHORITY TO VERIFY The above signed; a duly authorized representative of Applicant hereby certifies on behalf of Applicant that the information in this credit application is true, correct and complete. The information included in this credit application is for use by Price Engineering in determining the amount and conditions of credit to be extended. Applicant understands and acknowledges that Price Engineering may also utilize any other sources of credit information, which it considers necessary in making this determination. Applicant hereby authorizes the bank and trade references named in this application to release the documents and information to Price Engineering that Price Engineering deems necessary to assist it in determining whether to sell goods or extend credit to applicant. TERMS AND CONDITIONS If Price Engineering agrees to sell goods to Applicant on credit, Applicant agrees to pay all invoices in accordance with stated terms of N30 days from invoice date. If Applicant does not pay each such invoice on or before the date due, Applicant shall pay interest on the unpaid balance of each such invoice at the rate specified on such invoice or, if none is specified on any particular invoice, then at the rate of eighteen percent (18%per annum; i.e., 1.5 %per month), or at the maximum rate allowed by law, whichever is less. Credit and terms are offered at the sole discretion of Price Engineering, and may be terminated at Price Engineering’s sole discretion. Applicant also agrees to pay any court costs, attorney fees and costs of collection Price Engineering may incur in enforcing the terms of any invoice or other agreement of Applicant with Price Engineering. Each such invoice or other agreement, and the terms and provisions thereof, shall be governed in all respects by, and interpreted and enforced in accordance with, the laws of the State of Wisconsin (without giving effect to its choice of law rules.) Applicant understands and agrees that Price Engineering may disclose any portion of this application (A) in connection with or during any action, proceeding, or undertaking by Price Engineering or its agents, successors, or assigns to enforce or seek compliance of Applicant with the Terms and Conditions stated herein or in any invoice or other agreements with Price Engineering or (b) to the extent Price Engineering reasonably believes such disclosure is required by applicable law, court order or other legal process.

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Price On-Site Wisconsin

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Credit Application

Products Available: