Credit Application

Business Information
*
- Proprietorship
- Partnership
- Corporation
- LLC
- LLP
Established*
Years Under Current Ownership*
Years At Current Address*
Principals (owners if proprietorship, all general partners if partnership or officers with title if corporation):
Name*
Title*
Name
Title
Name
Title
Has any Principal of this company been involved in prior bankruptcy?*
- No
- Yes
If Yes, please indicate name and location of company:
A/P Contact Name*
Phone*
Fax
Duke Rentals, INC. CREDIT AGREEMENT

In consideration of Duke Rentals extending credit to the above business, applicant does hereby agree to individually or jointly pay for all products according to Duke Rentals’s payment terms. In the event that the account is placed with a third party for collection, applicant agrees to pay all costs, including attorney’s fees and court costs and agrees the venue for litigation will be in the state of Iowa. Execution of this document by the applicant or applicant’s agent shall serve as certification that the above furnished information is true and correct. Applicant agrees to advise Duke Rentals of any material changes in the statements and information provided to Duke Rentals pursuant to or with the credit application. The undersigned also warrants the applicant has read, understands and agrees to the Duke Rentals Credit Agreement and has the authority to apply for credit and make the statements herein.

Signature(s) Must be signed by owner, proprietorship, general partners if partnership or officer/agent if corporation.

I AM A SIGNATOR OF THE COMPANY AND HAVE A PERSONAL GUARANTEE TO THE ABOVE MENTIONED COMPANY. THE ABOVE INFORMATION IS FOR THE PURPOSE OF OBTAINING CREDIT AND IS WARRANTED TO BE TRUE. WE HEREBY AUTHORIZE THE ABOVE MENTIONED COMPANY TO INVESTIGATE THE REFERENCES LISTED PERTAINING TO MY/OUR CREDIT AND FINANCIAL STABILITY.
Signature*
Print Name*
Date*
MM slash DD slash YYYY
Signature
Print Name
Date
MM slash DD slash YYYY

CONFIDENTIAL CREDIT APPLICATION

Step 1 of 4

Contact Information

Business Information

Duke Rentals, INC. CREDIT AGREEMENT

Signature(s) Must be signed by owner, proprietorship, general partners if partnership or officer/agent if corporation.

Financial Information

Supplier References

Invoice Preferences