United Prairie Cooperative Business Credit Application

Transcription

1 United Prairie Cooperative Business Credit Application Hello and thank you for your interest in opening a United Prairie Charge Account. We hope that you will find doing business with us a pleasure and we always do our best to accommodate your business needs. Here are just a few friendly reminders for filing out the business credit application: Please be sure to include at a minimum of 3 trade references and 1 bank reference; Please include a fax number or for each reference provided, including your bank reference; and Please make sure all pages of the application are filled out completely. Thank you again for your interest and we look forward to doing business with you. If you have any questions regarding our terms, policies, patronage or other issues, please feel free to call us at (701) Monday through Friday 8:00 am to 5:00 pm CST 1 P age

2 UNITED PRAIRIE COOPERATIVE 307 Main Street PO Box 340 New Town, ND Phone: (701) Fax (701) Website: Address: BUSINESS CREDIT APPLICATION AND AGREEMENT Please print or type Date: Business Name: Address: Business Phone ( ) Fax ( ) Business Website: Name of Authorized Representative: Title: Representative's Home Address: Representative's Phone ( ) Federal l.d. No. State sales tax to be collected: Yes: No: If no, list State Sales Tax Resale Certificate No.: Dunn and Bradstreet No.: Billing/ Address (if different): Shipping Address (if different): Statements: Mail Management Company (if apartments): 2 P age

3 Company Information What types of Services and Products do you provide? Are purchase order numbers required on all invoices? Yes: No: Accounts Payable contact/ Phone ( ) What Products or Services and monthly dollar amount are you planning to purchase from United Prairie Cooperative? Date your business was established: How long at current business address: If less than I year, please give previous business address and previous business name, if applicable: Is your business (please check one): Sole Proprietorship: Partnership: LLC: Corporation: If LLC or corporation, date of organization/incorporation: State: If sole proprietor: Name Home Address Phone Social Security No. If partnership, LLC or corporation, list partners/members/officers: Name Title Home Address/Phone S.S. No If Division/Subsidiary, name of parent company: Parent company's business address: Date parent company was established: Name of company principal responsible for business transactions: Business's Annual Revenue: Number of Employees: 3 Page

4 References Trade References: Name Address/Phone Fax Number Address Account No Bank References: List information for principle bank 1. Name of Bank Address Phone Number Account No. Account Officer 2. Name of Bank Address Phone Number Account No. Account Officer 4 P age

5 CREDIT POLICY (AS ADOPTED BY THE BOARD OF DIRECTORS): UNITED PRAIRIE COOPERATIVE CREDIT POLICY 1. Credit will be allowed to those accounts who have a good prior credit record with this Company and to new accounts with an approved credit application. 2. The dollar amount of credit given to any individual or company will be determined by management. All credit decisions are FINAL. 3. When applying for a business credit account, all applications require either a letter of credit or earnest money/down payment. The amount required for the letter of credit or earnest money/down payment will be based on the amount of credit requested and approved. The only exception to this condition will be at the sole discretion of management and if sole discretion is so exercised, will require a personal guaranty from the applicant, in lieu of a letter of credit or earnest money/down payment. 4. The closing date of the billing cycle will be after the last day's business each month. Statements will be sent. 5. All accounts MUST BE PAID IN FULL by the 15th of each month following purchases. EXAMPLE: Your credit limited is $ you make purchase of $42.50 during the month ofjanuary. It does not matter if the purchase was on the 2nd or the 31st of the month, the TOTAL MUST BE PAID IN FULL on or before the 15th of February. We would appreciate the payment sooner, if possible. 6. A monthly finance charge of 1.75% (21% ANNUAL PERCENTAGE RATE) will be imposed on all delinquent accounts. Minimum service charge is $10.00 per month. 7. A CASHDISCOUNT may be applied on bulk fuels/gasolineor propane ifpaymentis received in ourofficewithin ten (10) days of delivery or pick up. You do not receive cash discount if you have an outstanding local charge that is sixty (60) days old or older; and you will not receive cash discount ifyou do not pay for delivery of bulk fuels/gasoline or propane within ten (10) days of pickup or delivery. (a) The cash discount given to any individual or company using cash for payment will be determined by management. (b) Cash discount applies only when paid by cash, personal check with sufficient funds, certified check or money order within the time allowed, or electronic funds transfer. 8. Company WILL NOT be responsible for regular scheduled delivery agreements on accounts that are PAST DUE. 9. PAST DUE ACCOUNTS will be turned over to a Collection Agency or a Suppliers Lien will be filed, if applicable, at the discretion of the manager. The cost of filing will be billed directly against the account. 10. On any PAST DUE ACCOUNT, the Company is authorized to apply any accounts payables of the individual or company to the balance due on the PAST DUE ACCOUNT, 11. Anyone who has had a BAD BILL or had COLLECTION PROCEDURE used against him/her will not be eligible for CREDIT. 12. To the extent allowed by applicable law, Applicant may be required to grant to the Company a contractual possessory security interest in, and may be required to assign, convey, pledge and transfer to the Company all of the Applicant's right, and interest in and to any and all accounts with the Company (whether in the form of deposit, earnest money or some other account), including without limitation all accounts held jointly with someone else and all future accounts opened with the Company. Applicant authorizes the Company, to the extent permitted by applicable law, to charge and setoff all sums due and owing on any account with the Company. 13. As a charge for using this alternate payment channel, a Convenience Fee of 3% will be imposed on all CREDIT transactions and will be included as part of the total transaction 14. By accepting credit from UNITED PRAIRIE COOPERATIVE, you are hereby agreeing to all the terms and conditions contained within this Credit Policy. We recommend that you use your lending institution for your credit needs over thirty (30) days. Our rate for an account over thirty (30) days is 21%. 5 P age

6 AGREEMENT I am an authorized representative of the Applicant requesting credit per the attached Application (hereinafter Applicant ) and herein agree to the following terms and conditions: 1. I am an authorized person and hereby certify that the information contained herein is complete and accurate and I understand that this information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. 2. If credit is granted, the Applicant shall promise to pay all bills when rendered. 3. If credit is granted, the Applicant hereby agrees to all the terms of conditions of United Prairie Cooperative's Credit Policy, incorporated herein by reference, as may be amended from time to time. 4. If any legal proceeding or collection action is taken with respect to any amount owed by Applicant, Applicant agrees to pay all expenses and costs, including attorney s fees, incurred by United Prairie Cooperative. 5. The Applicant shall not transfer or assign this agreement without the prior written consent of United Prairie Cooperative. 6. I give my permission, as an authorized representative of the Applicant, for United Prairie Cooperative to contact all companies and banks provided in the Credit Application to request that they release the Applicant s credit history to assist United Prairie Cooperative in determining whether and/or how much credit may be extended to the Applicant. As a condition to the extension of credit to Applicant, the Applicant must provide to United Prairie Cooperative either a letter of credit from a recognized lending institution or earnest money/down payment, which will be applied to the Applicant s account. The only exceptions made to this requirement will be at the sole discretion of management and instead of a letter of credit or earnest money/down payment, the principals of the Applicant will be required to provide a personal guaranty acceptable to United Prairie Cooperative. The amount required for the letter of credit or earnest money/down payment or personal guaranty will be based on the amount of credit that is requested and approved. Date: By: Its: CONTINUING PERSONAL GUARANTEE For the purpose of extending credit for the firm applying for credit listed above, the undersigned hereby absolutely and unconditionally guarantees, on a continuing basis, payment of all present and future indebtedness. This personal guarantee shall remain in effect until terminated by the undersigned by written notice to United Prairie Cooperative, in which event said guarantee shall still be applicable to any indebtedness of the firm listed above incurred prior to the date such notice is received by United Prairie Cooperative. Guarantor Date 6 P age

7 INDIVIDUAL CONSENT AND CERTIFICATION OF TAXPAYER I.D. NUMBER Name (as shown on Income Tax Return): Taxpayer ID No. (SSN or EIN): Billing Address: Phone: ( ) Date of Birth: I hereby consent to include in my gross income, as now or hereafter provided in the federal income tax laws, the stated dollar amount of each written notice of allocation which I receive from UNITED PRAIRIE COOPERATIVE, NEW TOWN, NORTH DAKOTA, with respect to my patronage occurring during the current and all subsequent taxable years of this cooperative. CERTIFICATION: Under penalties of perjury, I certify that (1) The number shown on this form is my correct taxpayer identification number (OR I AM WAITING FOR A NUMBER TO BE ISSUED TO ME), and (2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or ( c) the IRS has notified me that I am no longer subject to backup withholding. CERTIFICATION Instructions: You must cross out item (2) above, if you have been notified by the IRS that you are currently subject to backup withholding because of under- reporting interest or dividends on your tax return. However, if after begin notified by the IRS that you were subject to backup withholding, you received another notification from the IRS that you are no longer subject to backup withholding, do not cross out item (2). The Internal Revenue Service does not require your consent to any provision of this document, other than the certifications required to avoid backup withholding. Signature: Date: 7 P age

8 8 P age United Prairie Cooperative Cardholder Agreement Agreement made, between United Prairie Cooperative, a corporation organized and existing under the laws of North Dakota, with a place of business at 307 Main St, New Town, ND 58763, and, of. RECITALS A. United Prairie Cooperative (hereafter creditor ) operates the United Prairie Cooperative Credit Program (hereafter the Program ). B. In connection with the Program, creditor issues charge cards. A charge card will be issued to (hereafter patron or cardholder ) with a Personal Identification Number (PIN). The card remains the property of creditor. C. The dollar amount of credit given to any individual or company will be determined by management. All credit decisions are final. In consideration of the matters described above, and of the mutual benefits and obligations set forth in this agreement, the parties agree as follows: DEFINITIONS A. Card refers to a charge card issued in connection with an account under this agreement. This agreement covers the use of each charge card, including all cards with the same account number, issued to cardholder by creditor. B. "Account" means a United Prairie Cooperative credit account opened under this agreement. C. "Cardholder" shall mean, with respect to any charge card, the person whose name is embossed on the face of such card. A cardholder includes any person who is named on the account, any person whose name is embossed on a card, and any person who signs the card receipt form. The cardholder and all persons who use a card agree to be bound by this agreement. D. "Authorized user" shall mean, with respect to any charge card, the person whose signature appears on the card receipt form. RESPONSIBILITY FOR CARD 1.1 On receipt of each card, a cardholder must sign his or her name on the card receipt form. A cardholder is responsible for the use of a card and for the use of a card by any person who is given a card by the cardholder to use or to retain, or who is allowed by a cardholder to possess a card. A cardholder, or any person using a card, must immediately notify creditor if a card is lost or stolen. A cardholder may at any time cancel an account by notifying creditor in writing and surrendering all cards issued with the same account number to creditor, but the cardholder will remain liable for all outstanding purchases and other charges.

9 CARD USE AND LIABILITY 2.1 Each cardholder and any person who is given a card by the cardholder to use or to retain or who is allowed to possess a card by the cardholder, shall be jointly and severally liable to creditor to pay for all purchases of goods and/or services; for all accrued finance charges; and for any court costs resulting from legal proceedings brought to enforce this agreement. 2.2 Creditor shall not be responsible for the refusal of any merchant, provider of services, bank, or automated transaction machine to honor any card. 2.3 An account is the property of creditor, and its privileges may be terminated by creditor, or the particular credit card program may be canceled at any time, for any reason. All cards must be surrendered immediately on demand by creditor or its agents. 2.4 On communication from creditor that the account will be terminated and/or a demand for surrender of all cards of an account, no further purchases or cash advances may be obtained, and use of an account, after notice of its termination, shall be a violation of law. On termination, the entire outstanding balance of the account must be paid in full. MONTHLY STATEMENTS 3.1 Whenever transactions, charges, payments, or credits are posted to an account, creditor shall send a single monthly statement for the account at the end of the billing period to the cardholder whose name appears on the account on behalf of all cardholders and persons using or retaining a card with the same account number. A billing period is the number of days between the statement closing date on the previous statement and the statement closing date on the current statement. The statement shall contain all of the information required by law. The statement shall show, among other items, the following: the date and amount of all purchases and cash advances during the billing period; the previous balance from the last statement; all payments and credits made during the billing period; finance charges accrued; and the total new balance at the end of the billing period. PAYMENT 4.1 The minimum monthly service charge is $ If the total amount for all purchases, cash advances, and finance charges is not paid by the payment due date (the 15 th of the month following purchases), there shall at least be paid each month the total minimum payment as shown on the statement which is 1.75% (21% ANNUAL PERCENTAGE RATE or the highest amount allowed by law) of the total new balance of the account. The entire outstanding balance of the account may be prepaid at any time, which would include finance charges to the date of prepayment. No penalty or other charge will be imposed because of prepayment. 4.2 Creditor will not be responsible for regular scheduled delivery agreements on accounts that are past due. Past due accounts will be turned over to a Collections Agency or a Supplier s Lien will be filed, if applicable, at the discretion of the manager. The cost of filing 9 P age

10 will be billed directly against the account. On any past due account, creditor is authorized to apply any accounts payables of the individual or company to the balance due on the past due account. FINANCE CHARGES 5.1 Purchases. To avoid finance charges on all purchases made during each billing period, full payment of an amount equal to or greater than the sum of: (1) the purchases new balance shown on the statement; and (2) unpaid finance charges on cash advances, if any, as of the statement date must be made by the 15 day of each month following purchases. If not so paid, finance charges will be incurred on the principal portion of the purchases new balance as of the statement closing date as disclosed on the statement, and finance charges will be incurred on new purchases posted to the account during the next billing cycle from the date they are posted to the account. Finance charges are computed on purchases in the following manner: a. Start with the unpaid previous balance for purchases at the beginning of the billing period. Unpaid finance charges on previous purchases are excluded. b. If there is an unpaid previous balance, new purchases made during the current billing period will be added in from the date they are posted to the account. c. Each day's available payments and credits, unpaid finance charges on purchases, and any annual fees, late charges, return checks, and over-limit charges will be subtracted from the purchases balance. From this, a daily balance is determined. d. The daily purchase balances for each day of the billing period are added together and the total is divided by the number of days in the billing period. This results in the average daily balance of purchases. 5.2 Finance charges on advances and purchases shall be computed separately at monthly periodic rates of 1.75% (21% ANNUAL PERCENTAGE RATE or the highest amount allowed by law). RETURN CHECK CHARGES 6.1 If any payment is made on an account by a check (not drawn by creditor), money order, or other item that is returned unpaid after being sent for collection, a return check charge of $35.00, or a higher amount if creditor incurs fees in excess of $35.00, will be added to the account. DEFAULT 7.1 Certain events will be considered an act of default in this agreement, and creditor will then have the right to demand immediate payment for the entire unpaid balance of an 10 P age

11 account. Creditor will have this right without having to give prior notice or warning. The events of default are: a. the cardholder's death, or a court declaration that cardholder is incompetent; b. filing of a bankruptcy or insolvency action by or against cardholder; c. attachment or garnishment of a cardholder's property by a court; d. breach of any provision of this agreement; e. exceeding the credit limit on the account; or f. creditor in good faith believes cardholder and/or all persons using a card are unable or unwilling to pay the amounts creditor is owed under this agreement. Creditor will not lose any of its rights to enforce this agreement because it delays taking action or because it takes alternative action for any reasons. CREDIT INFORMATION 8.1 Creditor shall have the right to furnish information about an account and its payment status to other persons lawfully entitled to receive such information. SECURITY INTEREST 9.1 Creditor agrees and affirms that a security interest may be retained or acquired under this agreement. Cardholder agrees that his or her continued use of the account constitutes cardholder's affirmative consent to granting creditor a security interest in any deposit account cardholder may have from time to time with creditor. AMENDMENTS 10.1 Creditor may amend this agreement at any time by giving the written notice required by law to the cardholder whose name appears on the account on behalf of all cardholders and persons using or retaining a card, by mailing a copy of such amendment to cardholder's last known address as shown on the records of creditor Cardholder may validly refuse to accept amendments using the following instructions: If cardholder does not wish to accept the specific changes indicated, cardholder must notify creditor in writing stating your non-acceptance. Include cardholder name, address, and account number and mail to: PO Box 340, New Town, ND Upon receipt of cardholder notification of non-acceptance, cardholder account will be closed to further activity and cardholder agrees to pay all amounts due as required at the existing pricing terms. If creditor has not received written notice by the due date or if cardholder uses the account after notice of the amendments, cardholder will have agreed to the new terms outlined. Amendments will apply to cardholder account and the entire outstanding balance on cardholder account. 11 P age

12 10.3 All such amendments shall become effective as stated in the written notice and as allowed by law. Creditor may at any time in the future amend the applicable finance charge and annual percentage rate based on appropriate notice. If an account is used after the effective date of any such amendment to make a new purchase or to obtain a new cash advance, the new finance charge and annual percentage rate will apply to any existing previous unpaid balance on such account, as well as to the new transaction. APPLICABLE LAW 11.1 This agreement shall be governed by the laws of North Dakota. If any provision of this agreement is determined to be unenforceable by a court, the remaining provisions will remain in effect. If any legal proceeding or collection action is taken with respect to any amount owed by cardholder, or other action against cardholder, cardholder agrees to pay all expenses and costs, including attorney s fees, incurred by United Prairie Cooperative or its agents and assigns. EXPLICATING TERMS 12.1 In construing this Agreement, neither party shall be considered the drafter. Cardholder acknowledges that cardholder was provided an opportunity to consult with legal counsel prior to signing this agreement. By accepting credit from United Prairie Cooperative, cardholder hereby agrees to all the terms and conditions contained within this agreement. X Authorized Representative United Prarie Corporation Date Printed Name of Representative X Cardholder... Printed Name of Cardholder 12 P age

13 Card Order Form Name/Company Name: Account Number with United Prairie: Number of cards you will need: Patronage Only Cards: Fuel Restrictions (Listed Below): 0= Anything 4= Clear and Dyed Diesel Only Driver ID(Pin Number Four Digits #) Card #1: Card #2 Card #3 Card #4 Card #5 Authorized by Company Personnel: Date: Employee: If you have any question, please contact the Main Office at 307 Main Street New Town ND P age