Anderson Rentals, Inc. - Credit Application






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	Address: 1312 W. 6th St. Lawrence, KS 66044 Phone: 785-843-2044 Fax: 785-843-0045 E-Mail: Click Here



	Mon - Sat: 7:00AM - 6:00PM Sun: Closed in winter

Credit Application

credit application

Please fill out the Credit Application. We will reply as quickly as possible. If you would prefer, you can print this application and fax it to us at (785) 843-0045 . Thank you!
Company Name:
Fed ID or SSN:
Company Address:
Mailing Address: (if different)
Organization Type:	Corporation Sole Proprietorship Partnership
Contact Name:
Phone:
Fax:
E-Mail:
Nature of Business:
Years In Business:
Number of Employees:
Have you ever had credit with us before? If yes, under what name(s).	Yes No
Has any individual, firm, or any of its principles ever filed bankruptcy? If yes, please explain.	Yes No
Desired Credit Limit:
Home Address:
Please List Those Who Are Authorized To Pick Up Equipment:
Do You Require Purchase Order Numbers?	Yes No
Insurance Certificate - please send a certificate of insurance with Anderson Rentals, Inc. as the certificate holder.
Are You Tax Exempt? (If yes, please send a copy of your certificate)	Yes No
Please List Trade References:
Reference Name #1:
Reference Address #1:
Reference Phone #1:
Reference Name #2:
Reference Address #2:
Reference Phone #2:
Reference Name #3:
Reference Address #3:
Reference Phone #3:
Bank Information
Bank Name:
Bank Address:
Contact Person at Bank:
Bank Phone:
I, hereby certify to the above statements and agree to abide by the credit terms set forth by Anderson Rentals, Inc..
Date:

Please note: Customer is responsible for theft, damage, abuse and vandalism. Be sure of your insurance coverage. An insurance certificate may be requested. In making this application for credit, the customer agrees to pay all invoices within thirty days of the date of the invoice, and to pay a service charge of 2.41% per month, which is an annual percentage rate of 28.9% on all overdue balances. In the event a suit is necessary to collect any money, the customer agrees to pay the seller’s reasonable attorney fees and costs including attorneys fees for appeal. Personal guarantee: In consideration for credit extended, the undersigned contracts and guarantees to Anderson Rentals, Inc. the faithful payment, when due, of all accounts for five years from the date of this application. The undersigned guarantor expressly waives all notice of acceptance of this guarantee, notice of extension of credit, presentment of demand for payment and any notice of default by the company seeking credit and all other notices the guarantor may be entitled to. Revocation of the guarantee shall be in writing and delivered by certified mail.

A Family Owned Business Since 1946

Credit Application

Insurance Certificate - please send a certificate of insurance with Anderson Rentals, Inc. as the certificate holder.

I, hereby certify to the above statements and agree to abide by the credit terms set forth by Anderson Rentals, Inc..