Lift Rentals

Credit Application


Step 1 of 4

 

Sales Representative

How did you hear about us?

Business Name*

FEIN #

Address*

Address Line 2

City*

State*

Zip*

Billing Email*

Phone*

Fax

Preferred method to receive Invoices and Statements*

Point of Contact Name*

Point of Email*

Point of Phone*

If you are Tax Exempt, you will have to enter your # and attach your certificate*

Taxable or Tax-Exempt (Pick One)

If Tax Exempt Tax Exempt Number

If Tax Exempt (upload Tax Exempt Certifiate)

**Authorize NO site signature of terms & conditions upon delivery

Initial*

Date*

**Rental Agreement terms & conditions signed and returned

Initial*

Date*

Do you require a Purchase Order Number on Your Invoices? (Yes or No)*

Have you filed Bankruptcy, had Tax Liens or any Civil Suits Filed in the Past 5 Years? (Yes or No)*

Step 2 of 4

Officer, Owner, or Other Responsible Party Personal Information

Name*

Title*

Social Security Number

Address

Address Line 2

City

State

Zip

Email

Phone

Additional Officer, Owner, or Other Responsible Party Personal Information

Name

Title

Social Security Number

Address

Address Line 2

City

State

Zip

Email

Phone

Step 3 of 4

Business References

Firm/Name*

Email

Phone

Fax

Address

Address Line 2

City

State

Zip

Firm/Name*

Email

Phone

Fax

Address

Address Line 2

City

State

Zip

Firm/Name

Email

Phone

Fax

Address

Address Line 2

City

State

Zip

Step 4 of 4

Insurance Requirements: (Excluding equipment sales)

  • General Liability: $1,000,000
  • Equipment Floater: Coverage must be all risk, replacement cost coverage up to the value of the equipment rented; no boom/overload exclusions apply.
  • Time Savers, Inc. shall be named as additional insured and loss payee

I/WE ON BEHALF OF THE UNDERSIGNED ENTITY AGREE TO PAY FOR ALL THE CHARGES TO OUR ACCOUNT UNDER THE FOLLOWING TERMS AND CONDITIONS

Terms: Invoices are due net 30 from the date of invoice. At the discretion of Time Savers, Inc., any account with a delinquent balance may be placed on a cash basis at any time, and/or the equipment picked up without notice. The undersigned hereby agrees to pay all costs related to collect any unpaid balances, which includes but not limited to collections, court and attorney fees. I understand that there may be occasions when I am unable to execute Rental Agreements before equipment is delivered at job sites pursuant to my instructions and pursuant to my company purchase order/purchase approval and I hereby give Time Savers, Inc. a limited power of attorney to sign Rental Agreements on my behalf as my attorney-in-fact.

I hereby authorize the above listed bank, insurance company and business references, or others contacted at Time Savers, Inc. discretion to release credit and account information to Time Savers, Inc. for the purpose of establishing credit privileges or continuation of credit to a customer.

Must sign rental agreement page before any and all rentals
The Undersigned warrants the information listed on this application to be true, correct, and complete to his/her knowledge.

Date Signed

Please sign below

Leave this empty:

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Time Savers Aerials https://timesaverslifts.com
Signature Certificate
Document name: Credit Application
lock iconUnique Document ID: 786c83a7c5f364411562cef584da099c7cb3981f
Timestamp Audit
June 10, 2020 11:02 am CDTCredit Application Uploaded by Katie Hellman - [email protected] IP 98.32.196.195
June 10, 2020 2:39 pm CDT Document owner [email protected] has handed over this document to [email protected] 2020-06-10 14:39:02 - 98.32.196.195