Apply for Credit | Material Handling Portland, OR
Apply for Credit

BILL TO:

SHIP TO:
Name: Name:
Address: Address:
City: City:
State:   Zip: State:   Zip:
Phone: Phone:
Fax: Fax:
 

Business Type / Legal Structure:
Individual Sole Proprietor Partnership Corporation LLC Other
Federal Taxpayer ID#:    
Type of Business: SIC#:
Year(s) in Business: Year of Inc:    State of Inc:
For Resale: no yes (Send Completed Certificate)
 

Bank Reference:
Institution Name: Contact:
Address: City:   State:   Zip:
Phone:   ext.        Fax:   Account #:
 

Business References:
1) Company Name:  
  Address: City:    State:   Zip:
  Acct. No. Phone:   Fax:
2) Company Name:  
  Address: City:    State:   Zip:
  Acct. No. Phone:   Fax:
3) Company Name:  
  Address: City:    State:   Zip:
  Acct. No. Phone:   Fax:

The undersigned agrees that all purchases from F.E. Bennett Co. will be governed by F.E. Bennett Co.'s standard terms and conditions of sale as contained on the website. Any modification of such terms or any additional terms will not be binding upon F.E. Bennett Co. unless they are in writing and signed by F.E. Bennett Co. Any credit extended to the undersigned and the limits of such credit shall be at F.E. Bennett Co.'s sole discretion and may be reduced or revoked at any time and for any or no reason.  Should F.E. Bennett Co. approve this application, I (we) agree to pay for all goods purchased within thirty (30) days of invoicing.  F.E. Bennett Co. is authorized to contact any references or banks listed above.  It is understood that any information so obtained will be used solely for the granting of credit.  Should it become necessary to collect this account by legal proceedings or otherwise, THE UNDERSIGNED, INCLUDING ENDORSERS, PROMISES TO PAY ALL COST OF COLLECTION, INCLUDING REASONALBLE ATTORNEY FEES.

Authorized Signature: Title:
Print Name: Date:
 
  

 
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Contact us at 1.866.201.4271 or customerservice@febennett.com
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