credit agreement - Hardware Suppliers of America, Inc.

ACCT. #
CREDIT AGREEMENT
CODE #
hardware suppliers of america, inc.
ENTERED
1100 Killian Road, Akron, OH 44312
phone 800-334-5625 | fax 800-334-5635
APPROVED
company
information
Company Name:
BILLING ADDRESS:
SHIPPING ADDRESS:
City / ST / Zip:
City / ST / Zip:
Phone:
Type of ownership:
Fax:
❑ Sole Proprietorship
Phone:
❑ Partnership
❑ Corporation
Fax:
Date of Incorporation:
Invoice / Statement delivery preference: ❑ E-mail to this address:
❑ Fax to Accounting - Fax #
Attn:
❑ U.S. Mail
Payment Cycle:
Estimated monthly credit required:
Federal I.D. or S.S.#:
State Tax Exempt* #:
Name:
Name:
Address:
Address:
City / ST / Zip:
City / ST / Zip:
Title:
Title:
Company:
Company:
Address:
Address:
City / ST / Zip:
City / ST / Zip:
Phone:
Email:
Company:
Company:
Address:
Address:
City / ST / Zip:
City / ST / Zip:
Email:
bank
information
Phone:
Email:
Phone:
terms and conditions
of sale
Fax:
Fax:
Fax:
Phone:
Fax:
Email:
Bank Name:
Account #:
Address:
Contact:
City / ST / Zip:
Phone:
Fax:
I agree to pay my account in accordance with Hardware Suppliers of America, Inc.’s terms of Net 30 days. I agree to pay all costs in the collection of past due
payments whether or not a suit of action is file. If litigation is commenced, I agree to pay such additional sums as the court may be judged reasonable as
attorney’s fees in the litigation, or any appeal therefrom. Should a dispute arise, the laws of the State of Ohio and the terms and conditions of this credit
agreement shall govern. All disputes must be filed in the State of Ohio, County of Summit. Hardware Suppliers of America, Inc. is hereby authorized to investigate
all trade references and obtain information from credit reporting agencies. In the event of checks being returned by the bank for insufficient funds, I agree to pay
the current bank rate per check returned. I understand that credit is extended by Hardware Suppliers of America, Inc. for my convenience and that Hardware
Suppliers of America, Inc. shall have the right to terminate this agreement at any time without notice to me. I agree that upon termination of this credit
agreement, all sums owing on the date of termination shall be immediately due and payable, together with charges applicable thereto. The information herein
contained is complete and truthful.
I have read and accept the terms and conditions of sale shown on this credit agreement.
COMPANY:
BY:
DATE:
TITLE:
050115
trade
references
principal
owners
*REQUIRED - CERTIFICATE ON FILE REQUIRED FOR COMPANIES LOCATED IN: AZ, CA, OH, TN, PA, NC, TX
CREDIT AGREEMENT - Page 2
please list sales, purchasing, and other key contacts within your organization:
Name:
Title:
E-mail:
❑ Send email correspondence regarding news and information from HSI to this contact?
Name:
Title:
E-mail:
❑ Send email correspondence regarding news and information from HSI to this contact?
Name:
Title:
E-mail:
❑ Send email correspondence regarding news and information from HSI to this contact?
please list branch locations (if applicable).
Account Name:
Branch Contact:
Address:
City:
Phone:
Fax:
ST:
Zip:
ST:
Zip:
E-mail:
Account Name:
Branch Contact:
Address:
City:
Phone:
Fax:
E-mail:
which of the following best describes your company?
❑ Contract distributor of builders hardware ❑ Locksmith shop
❑ Access control systems integrator
❑ Residential Hardware Distributor
❑ Wholesale distributor builders hardware ❑ Wholesaler of locksmith supplies ❑ Distributor of access control products
❑ Distributor of doors and frames
❑ Glass and glazing contractor
❑ Lumberyard / Buying Group
❑ Other
please indicate the categories of products you are currently involved in.
❑ Mechanical locks, Door closers, Exit devices
❑
❑ Integrated access control systems
❑ Push Button Locks
❑ Card readers / Keypads
❑ Power supplies / Batteries
❑ Residential Hardware
please check the manufacturers that you currently have an open account with.
❑ ACSI
❑ Dorma
❑ Kaba Access
❑ Medeco
❑ Sargent
❑ Adams Rite
❑ Falcon
❑ Kaba Ilco
❑ Monarch
❑ Schlage
❑ Arrow
❑ Folger Adam
❑ Kwikset
❑ Norton
❑ Securitron
❑ Baldwin
❑ Hager
❑ LCN
❑ PDQ
❑ Von Duprin
❑ Corbin Russwin
❑ HES
❑ McKinney
❑ Rixson
❑ Yale
please check any manufacturer whose products you purchase through wholesale distribution.
❑ ACSI
❑ Dorma
❑ Kaba Access
❑ Medeco
❑ Sargent
❑ Adams Rite
❑ Falcon
❑ Kaba Ilco
❑ Monarch
❑ Schlage
How often do you purchase from wholesalers?
❑ Arrow
❑ Folger Adam
❑ Kwikset
❑ Norton
❑ Securitron
❑ Daily
❑ Weekly
❑ Baldwin
❑ Hager
❑ LCN
❑ PDQ
❑ Von Duprin
❑ 2-3 times per month
❑ Corbin Russwin
❑ HES
❑ McKinney
❑ Rixson
❑ Yale
❑ Monthly
which of the following best describes your company’s purchasing process?
❑ A centralized purchasing department processes all P.O.’s
❑
❑ Other (explain)
Preferred method of ordering:
❑ Phone
❑ Fax
❑ E-mail
❑ On-line order entry
questions or comments... please call us toll free at 800-334-5625