Application For An Open Account

Date: _________________

 

Full Company Name:___________________________________________________________________

Physical Address:_____________________________________________________________________

Billing Or Mailing Address:_______________________________________________________________

Phone 1:________________ Phone 2:_______________

E-Mail:_________________________________

Type Of Business:______________________________________________

Date Started:______________

Is Your Company Incorporated?_____ Your Federal ID Number:_______________________

Principle Owner(s) Or Officers(s):______________________________________________

Business Operates As: Individual____ Partnership____ Corporation____

Business Operates From: Residence_____ Shop_____ Office_____

Business Property: Rented______ Owned_____

If Rented,From Whom?_______________________________Phone____________

Is Company Bonded? Yes_____ No______

Tax Exempt? Yes_____ No_____, If Yes, You Must Include A Tax Exemption Form With This Application Before We Consider You Exempt.

Accounts Payable Manager's Name:_____________________________________________

Do You Require Purchase orders On Invoices? Yes_____ No_____

Do You Require Job Name___ Location____ Or Number___ On Invoices? Please Check All That Apply.

Must All Charges Be Authorized By Your Office? Yes____ No____

If Yes, By Whom?____________________________

Are There Certain Persons Allowed To Charge, Or Pick Up Equipment? Yes____ No____

If Yes, Please List Names Below:

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Have You Rented Tools From Any Other Rental Company? Yes____ No____

If Yes Please List Their Name And Phone Number :_________________________________________

In Order For Application To Be Processed, You Must Give Complete Name, Address, And Phone Of Six(6) Trade Suppliers With Whom You Have Done Business. No Application Will Be Processed Without This Information. Do Not Use Charge Cards Or Subcontractors.

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

Name:________________________________________________

Address:______________________________________________

Phone::__________________________________

 

Please Read and Sign The Following :

1. THE UNDERSIGNED HEREBY AGREES THAT OUR TERMS OF SALE AND RENTAL ARE NET 30 DAYS FROM THE DATE OF THE INVOICE. ANYTHING THAT IS NOT PAID WITHIN THESE TERMS BECOMES PAST DUE, AND A SERVICE CHARGE OF 1 ½% PER MONTH (18% PER ANNUM) WILL BE ADDED ON ANY PAST DUE PORTION AND MUST BE PAID IN FULL. IF THE ACCOUNT SHOULD RUN OVER 60 DAYS PAST DUE, THE ACCOUNT WILL BE PLACED ON A HOLD STATUS UNTIL ALL PAST DUE INVOICES AND FINANCE CHARGES ARE PAID IN FULL. THIS CAN BE DONE WITHOUT NOTIFICATION TO THE ACCOUNT HOLDER.
2. PURCHASER AGREES TO EXAMINE ALL INVOICES AND STATEMENTS PROMPTLY UPON RECEIPT AND TO NOTIFY SELLER IMMEDIATELY OF ANY FAILURE OF DELIVERY, SHORTAGE, DISCREPANCY, OR ERROR. PURCHASER FURTHER AGREES THAT SUCH INVOICES OR STATEMENTS SHALL BE PRESUMED CORRECT UNLESS OUR OFFICE IS NOTIFIED IN WRITING WITHIN 21 DAYS OF SUCH FAILURE OR DELIVERY, SHORTAGE, DISCREPANCY OR ERROR. IT SHALL BE PRESUMED THAT THE PURCHASER RECEIVED INVOICES, AND STATEMENTS ON OR BEFORE THE FIFTEENTH (15TH) DAY OF THE MONTH SUCCEEDING PURCHASE.
3. IN THE EVENT OF DEFAULT OF PAYMENT AND IF THE SAME IS PLACED FOR COLLECTION, THE UNDERSIGNED AGREES TO PAY THE FULL AMOUNT, PLUS ENTIRE COLLECTION COST, INCLUDING A 15% ATTORNEY’S FEE AND ANY COURT COST FINES.
4. THE UNDERSIGNED AGREES THAT ANY CHANGES OR OWNERSHIP, OFFICERS, OR FORM OF BUSINESS SHALL BE MADE KNOWN IN WRITING TO EAST TENN. RENT-ALLS, INC., P.O. BOX 3856, JOHNSON CITY, TN 37602.
5. THE UNDERSIGNED DOES HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT.

OWNERS, PARTNERS, OR OFFICIAL SIGNATURE _____________________
OFFICIAL TITLE: __________________ DATE: __________________________

ATTACHED IS A COPY OF OUR RENTAL EQUIPMENT PROTECTION PLAN. IF YOU CHOOSE NOT TO ACCEPT THE REPP, WE WILL NEED A COPY OF YOUR CERTIFICATE OF INSURANCE FROM YOUR INSURANCE CARRIER SHOWING COVERAGE OF RENTAL EQUIPMENT AND THE POLICY AMOUNT AND EXPIRATION DATE. YOU MAY FAX THE CERTIFICATE TO OUR OFFICE AT 423-283-4149.

East Tennessee Rent-Alls, Inc.
Rental Equipment Protection Plan (REPP)
THIS PROTECTION PLAN IS NOT INSURANCE AGAINST ANY LOSS OR DAMAGE

If accepted by renter, Lessor (East Tennessee Rent-Alls, Inc.) agrees in consideration of an additional charge of 10 percent of the gross rental charges on this contract and its subsequent periodic invoices, to modify the responsibility of RENTER as indicated below, file a report with the proper law enforcement authorities, and furnish a copy to Lessor within 48 hours of the incident.
By renter accepting the REPP, Lessor waives certain claims against the renter incurred from the direct loss of the rental equipment by fire, theft, or burglary (provided there is evidence of forced entry) of the rental equipment or vandalism of the rental equipment except as follows:
1. Scaffolding and all scaffolding accessories.
2. Theft (other than burglary), abuse, theft by conversion, theft by persons entrusted with the equipment, intentional destruction, loss due to mysterious or unexplained disappearance.
3. Damage or loss occasioned by acts of God (windstorm, hail, lightning, flood, etc.).
4. Damages resulting from neglect or misuse.
5. Use of the equipment in violation of any of the terms of this contract.
Renter’s Liability to Lessor is a deductible in the amount of the FOUR (4) WEEKS rental fee for the equipment listed on the front of this contract of each claim for loss as a result of fire, theft, or vandalism. Accessories such as air hoses, tool steel, electric cords, blades, welding cables, and other similar items are excluded from this plan. Renter’s payment of Lessor’s invoice with the REPP will be considered acceptance of the REPP. Accrued rental charges cannot be applied against any deductible. Renter agrees to
If Renter has Insurance covering loss of Rented Equipment, Renter shall have their Insurance company provide Lessor, in advance of any rental a certificate of insurance indicating sub-limit dollar amount for equipment rented from others. Renter shall exercise all rights available to them under said insurance, take all action necessary to process said claim and renter further agrees to assign said claim and any and all proceeds from such claim from such Insurance to Lessor.
NOTE: CERTIFICATE OF INSURANCE MUST SPECIFICALLY STATE THAT COVERAGE IS EXTENDED TO RENTED EQUIPMENT. FAX CERTIFICATES OF INSURANCE TO (423) 283-4149, OR MAIL TO EAST TENN. RENT-ALLS; P.O. BOX 3856, JOHNSON CITY, TN 37602; ATTN: JOSH BAXTER
If Renter Declines the REPP, the renter agrees to pay and be responsible for any and all loss or damage to the equipment until same has been returned to the Lessor, whether or not such loss or damage to the equipment is due to the negligence of the renter, their agents, or employees. In the event equipment is lost or stolen, the renter agrees to be responsible for actual cash value of said equipment. Accrued rental charges cannot be applied against the actual cash value of said equipment. The cost of any repairs will be borne by the renter, whether performed by Lessor, or, at Lessor’s option, by others.
LESSOR RESERVES THE RIGHT TO CANCEL THIS PROTECTION PLAN BY MAIL
COST OF THE REPP IS 10% OF THE GROSS AMOUNT OF RENTAL CHARGES ON THIS CONTRACT AND IT’S SUBSEQUENT INVOICES