Failure to provide the necessary information will result in your application being delayed.

Transcription

1 WISP-Router, Inc. 264 N. Industrial Drive Frontenac, KS Phone Fax Your Full Time Professionals Dear Customer: Please find attached the Customer Credit Application for WISP-Router, Inc. Please note that this form must be completed in it s entirety with the exception of the following: 1) A pre-printed list of vendor credit references can be attached in lieu of filling out our form; please be sure to include your banking information if you are using your own list, or make sure that the banking information is filled out on our form. 2) The Personal Guarantee need not be signed if your company is a Corporation. However, if your company is a sole proprietorship or an LLC, this form MUST be signed by the owner or all of the managing partners of the LLC. There are no exceptions. 3) The Agreement to our Terms and Conditions MUST be signed by an officer of the corporation who has the authority to bind your company to such a contract. Failure to provide the necessary information will result in your application being delayed. In addition to the above, we would like to give you some of the criteria that we employ in determining credit worthiness to our company: 1) We will review your payment history with other vendors. Those that habitually do not pay within the terms offered for several of the credit references provided will result in a rejection of your credit application. 2) We also take into consideration the length of time we have had a business relationship under other terms. First time customers will not be granted credit, and should have a history with WISP-Router, Inc. for a minimum of three months with other payment methods being employed. 3) We do check with all of the supplied trade references. Please note that references for services (i.e., telephone, internet, electric, etc.) will not be considered as credit references. Please make sure your references are for equipment and/or other tangible items. If you have any questions, please do not hesitate to ask. Thank you for your cooperation. Regards, Beverly Gustafsson CFO WISP-Router, Inc. Page 1 of 5

2 WISP-Router, Inc. 264 N. Industrial Dr., Frontenac, KS Crreeddi itt Appppl liccaat tioonn Phone: (620) Fax: (620) Company/Customer Information (please fill in ALL blanks) Complete Legal Name Telephone ( ) Fax ( ) Business Address City State Zip Mailing Address City State Zip Since DUNS Number: Business Structure Credit Requested (circle one)* Net 20 Terms Amount of Credit Requested:* *Failure to disclose will delay your application. COD Company Check Corporation, Publicly held Corporation, Privately held Partnership, General Division or Subsidiary Sole Proprietorship Partnership, Limited Name of Parent Corporation Address City, State, Zip State of Incorporation If a Corporation, please attach appropriate documentation to substantiate corporate status Licensing Information Social Security No. Tax Exempt? Yes No (if yes, attach certificate) Federal Tax No. Resale/Use Tax No. Bank References (attach additional sheets for each additional bank references) 1. Name Contact Officer Address City, State, Zip Checking Account No. Balance No. Overdrafts Telephone Fax Savings Account No. Balance Loan No. Business Personal Balance Secured? Yes No Page 2 of 5

3 Trade References (Please make sure that the companies listed below are willing to provide credit references, or processing of your credit application could be delayed Electric or Phone companies are NOT acceptable as Trade References) 1. Name Contact Person Terms Telephone Fax Credit Limit 2. Name Contact Person Terms Telephone Fax Credit Limit 3. Name Contact Person Terms Telephone Fax Credit Limit Company Principals or Officers (Responsible for business transactions if partnership, attach additional sheets if necessary to list ALL Members of the Partnership) Home Address Telephone SS No. Home Address Telephone SS No. Home Address Telephone SS No. Miscellaneous Does business have any debts under a name other Do you require a purchase order? Yes No than the one used on this credit application? Do you use purchase order numbers? Yes No Yes No Please list the person(s) or position(s) authorized If Yes, list name to issue P.O.s: Does business have any past due debts? Yes No (Please attach additional sheets if necessary) If Yes, where? Estimated monthly purchases Has business ever filed for bankruptcy? Will you send a confirming purchase order on Yes No phone orders? If Yes, when? Yes No Page 3 of 5

4 This contract shall be constructed to have been made and entered in Frontenac, Kansas, on the date subscribed below, by and between WISP-Router, Inc., a Kansas corporation, herein after referred to as WISP-Router, Inc., and Applicant(s) for the purpose of establishing an open account for applicant under terms and conditions as follows: 1. Applicant, whether maker, endorser, surety or guarantor (all of whom are included in the term ( Applicant ) applies for credit and agrees to be bound hereunder and make payment as may be specified within any Invoice or Statement received from WISP-Router, Inc.; examples COD, Net 10 days, etc., as may be determined by WISP-Router, Inc. from time to time. Approval of credit and continuation of the account is discretionary with WISP-Router, Inc., which discretionary authority may be entirely arbitrary in its exercise. In consideration for WISP-Router, Inc. establishing an open account and possibly extending credit to the Applicant on a revolving basis, Applicant agrees to be bound by the terms and conditions specified herein or as modified by any WISP-Router, Inc. Invoice or Statement hereafter. Applicant acknowledges, understands and consents to the fact that WISP-Router, Inc. may, through change of the Terms and Conditions evidenced within any Invoice or Statement from time to time, modify the Contract Terms and Conditions herein from time to time with or without notice. Applicant waives any and all claims Applicant may have and agrees to hold WISP-Router, Inc. harmless for any decision WISP-Router, Inc. may make as to maintenance of an account with Applicant or the modification of payment conditions and terms. 2. All right, title and interest in and to all property delivered to Applicant shall remain with WISP-Router, Inc. until fully paid. Payment shall, whether in whole or in part, be applied on a first delivered, first paid basis. 3. This agreement shall be governed under the laws of the State of Kansas. Ay action brought under this Agreement or involving in any manner whatsoever the relationship WISP-Router, Inc. and Applicant shall be determined under Kansas law. Applicant hereby consents to submit to jurisdiction of the state or federal courts of the State of Kansas and agrees that such Courts within Crawford County, State of Kansas, shall have original exclusion jurisdiction over all matters and disputes between the parties hereto regardless of the origin of such disputes and agrees that personal jurisdiction shall reside with such courts for purposes of any action or proceeding on or related an agreement between WISP-Router, Inc. and Applicant. Should Applicant be a corporation or other business entity, the signatories hereto personally guarantee, affirm, and assure that they have authority to bind such business entity. 4. Applicant shall be in default if any of the following events occur: (a) upon WISP-Router, Inc. deeming itself insecure; or (b) upon Applicant s failure to make payment at the time when and where the same become due and payable; or (c) upon Applicant s failure to perform any other obligation to WISP-Router, Inc., or (d) upon the death or insolvency (however evidenced) of Applicant; or (e) upon the commission of an act of insolvency or the making of a general assignment for the benefit of creditors by Applicant; or (f) upon the filing of any petition or the commencement of any proceeding by or against the Applicant for any relief under any bankruptcy or insolvency laws, or any laws relating to the relief of debtors, readjustment of indebtedness, reorganization, compositions or extensions; or (g) upon the suspension of the transaction of the usual business of the Applicant; or (h) upon the dissolution, merger, consolidation or reorganization of Applicant; or (i) if any representation or warranty, whether oral or written, by Applicant to WISP-Router, Inc. be materially untrue. Upon default, WISP-Router, Inc. may retake its property by any peaceable means and to do so can enter any of Applicant s properties. 5. In the event of any such default, Applicant (a) agrees to pay WISP-Router, Inc. all lawful collection costs and legal expenses, including reasonable attorney s fees, with or without suit; (b) agrees that any Invoice or Statement at the rate of 1.5% compounded monthly (18% per anum) until date paid. Waiver of any default shall not constitute a waiver of any subsequent default. 6. Execution of this Contract authorizes WISP-Router, Inc. to verify with credit reporting agencies, any information or representation which may be provided in the statement and to exchange WISP-Router, Inc. credit experience with credit reporting agencies, other creditors of the Applicant or others. 7. WISP-Router, Inc. is hereby authorized to contact the references provided, banks listed hereon and any other source deemed by WISP- Router, Inc. to be material and obtain any information in such files pertaining to any and all funds, accounts, records, history, accounting, deposits, withdrawals and / or all related or additional information. Such persons are hereby directed to release information upon request. WISP-Router, Inc. and the repository of records; agency; any employer, or business establishment including its officers, employees, or related personnel both individually and collectively, are hereby released from any and all liability for damages of whatever nature caused by or resulting from compliance with this authorization and request for information or any attempt to comply herewith. Applicant hereby certifies that the information given on this application is true, complete and correct. Applicant understands that WISP- Router, Inc. will rely on the truthfulness, and completeness in granting credit to the applicant. Applicant further certifies that they fully understand all terms and provisions of this contract and has received a copy of this contract. (Note: Signatures must be Officers if a corporation. All partners must sign.) Page 4 of 5

5 Personal Guarantee (Must be signed only if company is a Sole Proprietorship or Partnership) For good consideration, and as an inducement for WISP-Router, Inc. (Creditor) to extend business terms to ( Applicant ), it is hereby agreed that the undersigned (Insert either your business name or your name here for this to be a valid document) does hereby guaranty to Creditor prompt, punctual and full payment of all monies as may now or hereinafter be due Creditor from Applicant. This guarantee is unlimited as to the amount or duration and shall remain in full force and effect not withstanding any extension, compromise, adjustment, forbearance, waiver, release or discharge of any party obligor or guarantor and the undersigned waives all notices of the foregoing. The obligations of the undersigned shall at the election of the Creditor be primary and not necessarily secondary and Creditor shall not be required to proceed first or exhaust its remedies against Applicant prior to enforcing its rights under this guaranty against the undersigned. The guaranty hereunder shall be unconditional and absolute and the undersigned shall waive all right of subrogation or set off until all sums due under this guaranty are paid in full. The undersigned further waives generally, all suretyship defenses in the paid upon demand, then the including the cost of servicing for the legal process. If there are two or more guarantors to this guaranty, the obligations shall be joined and several and binding upon an inure to the benefit of the parties, their successors, assigns and personal representatives. Each of the undersigned warrants and represents its full authority to enter into this guaranty. This guaranty shall be constructed and enforced under the laws of the Crawford County, in the state of Kansas. Please note the additional information below: If there are questions regarding this credit application, whom should we contact? Name: Phone: Fax: Please make sure that you provide a valid address. WISP-Router, Inc. invoices are sent out via ONLY and this will be the only way you will receive a copy of an invoice due on terms. Continual failure to pay this account within terms provided will result in the terms on this account to be suspended. Thank you. Please also note that it can take two to three weeks for credit references provided to respond to our enquiries. Please allow ample time for your application to be processed. If you have a pending order that is urgent, we suggest that you pre-pay for this order while your credit application is being processed. Page 5 of 5