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Please check any of the following that apply:
Please Send Me a Catalog: I Need To Place an Order:
Owner/Manager Company
*Field is Required
Email*:
Name*:
Address*:
City*: , State*:
Zip*:
Phone*: Fax:
Number of Years in Business:
Type of Business:
Mangement Type: Fee Managed:
Owner Managed:
Principals of Business:
Is Purchase order Required? Yes No
Authorized Purchasers:
Over What $: Amount of credit requested:
Do you accept back orders: Yes No
Comment:
Tax Exempt: Yes
No
Please fax certificate to: 1-800-345-0209 or email to
accountinfo@industrialedge.com
Mail Invoice To: Owner/Management Property
Ship Merchandise To: Owner/Management Property
Total # of Properties Owned/Managed: Total # of Units:
Property Information
Property Name:
Address:
City: , State:
Zip:
Phone: Fax:
E-mail additional properties to accountinfo@industrialedge.com
Multi-Housing
Apartment House:
Condominium:
Hotel/Motel:
Housing Authority:
Commercial:
Office Building:
Shopping Center:
Other:
Healthcare:
Hospital:
Nursing Home:
Institution:
School:
Religious Facility:
Government:
Other:
Payment Method:
Credit Card Number:
Expiration Year:
Expiration Month:
Security Code:
Name:
Address:
City: , State:
Zip:
Bank Information:
Bank Name:
Address:
City: , State:
Zip:
Phone: Fax:
Type Of Account: Checking: Savings:
Loan:
Account #:
Active Trade References:
(Hardware, Maintenance Supplies, Building Supplies)
Company Name:
Phone: Fax:
Account #: Credit Limit $:
Company Name:
Phone: Fax:
Account #: Credit Limit $:
Company Name:
Phone: Fax:
Account #: Credit Limit $:
Terms:
Terms of Payment: Invoices are mailed daily and are due 30 days from the
invoice date. 1-1/2% per month 18% per year is charged on past due invoices.
Orders may not be processed if account is delinquent. In the event of any legal
action brought by either party under this agreement, the prevailing party shall
be entitled to recover all costs and expenses including attorney fees.
Agree Disagree
Sales Tax: Customers who are tax exempt from sales tax must fax a certificate
of exemption to 1-800-345-0209.
Transmission of an account application to Industrial Edge USA over the internet has the same legal effect as
your signature on a written credit application transmitted to our attention. Please be guided accordingly.
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