Certificate and Food Handler Guide Order Form

GENERAL TERMS AND CONDITIONS AND PERSONAL GUARANTEE

1. A service charge of 2% per month will be added to all amounts billed if not paid by due date.
2. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.
3. PERSONAL GUARANTEE: If the credit customer is a corporation, then those signing this application, whether signing as an officer or not, personally guarantee payment for all items purchased on credit by the corporation.

Credit Application

Company Name
DBA (if different)
Contact Person*
First Last
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Phone
Federal Tax ID or Social Security Number*
Type of business
Date Business Established
MM slash DD slash YYYY
Types of products you will purchase
Amount of credit requested $*
Are you a*
State of Incorporation*
Name of Chief Corporate Officer #1*
First Last
Title
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of Chief Corporate Officer #2*
First Last
Title
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of Chief Corporate Officer #3
First Last
Title
Address
Street Address Address Line 2 City State ZIP Code
Name of Partner
First Last
Address of Partner
Street Address Address Line 2 City State ZIP Code
Are you sales tax exempt?*
- Yes
- No
Have you ever had credit with us before?*
- Yes
- No
Under what name?
Authorized Purchaser
First Last
Purchase order required?
- Yes
- No
Trade Reference #1*
First Last
Account #
Phone
Address
Street Address Address Line 2 City State ZIP Code
Trade Reference #2*
First Last
Account #
Phone
Address
Street Address Address Line 2 City State ZIP Code
Trade Reference #3*
First Last
Account #
Phone
Address
Street Address Address Line 2 City State ZIP Code
Bank Reference #1*
First Last
Name of Bank*
Account #*
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Bank Reference #2*
First Last
Name of Bank*
Account #*
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Authorized Signature
I represent that the above information is true and is given to induce to extend credit to the applicant. My company and I authorize to make such credit investigation as sees fit, including contacting the above trade references and banks and obtaining credit reports. My company and I authorize all trade references, banks, and credit reporting agencies to disclose to any and all information concerning the financial and credit history of my company and myself. I have read the terms and conditions stated below and agree to all of these terms and conditions.

Credit Application

Supplies Testing

We offer free deliveries
with NO minimums

Certificate and Food Handler Guide Order Form

Supplies we carry

GENERAL TERMS AND CONDITIONS AND PERSONAL GUARANTEE

Credit Application