Type of Business:CorporationPartnershipProprietorship
Name of Business:
Phone Number:Fax Number:
Partners (if any):
Note: Please only list those vendors that sell to you on open accounts.
Does your business require purchase orders? YesNo
List name(s) of person(s) authorized to request service for your business.
Terms and Conditions
All invoices are due on the 15th of the month following purchase of service.
All invoices past due after sixty (60) days shall accrue a finance charge of 1 1/2 % per month (18% per annum) on the past due amount.
In the event of non-payment, the customer agrees to pay all reasonable costs in securing full payment, including, but not limited to collection and attorney fees, including all court costs.
I have read and understand the above terms and conditions. I hereby certify that the business/corporation listed herein is licensed and authorized to conduct business within the State of Alabama.