Scaffolding Today Inc.
11827 Eastex Freeway, Houston, Texas 77039
P.O. BOX 11643 Houston, Texas 77293
Phone: 281 449 7900  Fax: 281 449 7904
www.scaffoldingtoday.com



CREDIT APPLICATION


Business Name:
Billing Address:
Adress #2:
City: State: Zipcode:
Phone #: Fax: Email:
Contact Person: Contact Postion:
Driver License: State of Driver License:
Type of Ownership: (Sole Proprietership, Corporation, LLC)
Purchase order required? (Yes or No)
Principals Name and Title

BANK INFORMATION


Banking Institution: City: State:
Contact Person: Phone #: Account #:

BUSINESS/CREDIT REFERENCES – OPEN ACCOUNTS


1) Company:        2) Company:
Contact Person:        Contact Person:
Address:                   Address:
Phone #:                   Phone #:
Comments:               Comments:

3) Company:        4) Company:
Contact Person:        Contact Person:
Address:                   Address:
Phone #:                   Phone #:
Comments:               Comments:



AGREEMENT REGARDING EXTENSION OF CREDIT

WHEREAS,
Scaffolding Today, Inc. agrees to extend credit to: upon credit approval. In Consideration of the extension of credit, I , render myself “PERSONALLY LIABLE” on behalf of the business entity referenced herein on all current and future credit purchases and credit extensions. I personally guarantee to pay interest at a rate of 1.5% per month or 18% A.P.R. on all past due accounts. I promise to pay all reasonable attorney fees, collection agency fees, court costs and legal fees in the event of default or failure to pay in accordance with credit terms herein.

____________________________________________ (Sign Individually – not as a Corporate Officer) (Date)

____________________________________________ (Sign Individually – not as a Corporate Officer) (Date)