Application for Credit Terms | Coolgear

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1Introduction

2Business Information

3Bank References

4Contact Information

5Business/Trade References

6Signatures

7Credit Authorization

8Attachments

Apply for Credit Terms
Use the form on the following pages to apply for credit terms.

Please complete and sign all required sections. You may attach a copy of your company credit reference sheet on page.

After submission, we will run your business credit, speak with your references, and get back to you about the status of your application within 3 business days.

Business Information
Your Name*
First Last
Legal Company Name*
Phone*
Fax
Email*
Registered Company Address*
City*
State*
Zip Code*
Date Business Commenced*
Type of Business*
- Corporation
- Partnership
- LLC
Requested Terms*
- NET1
- NET7
- NET10
- NET30
- NET45
- Other
Tequested Terms : Other

Bank References
Bank Name*
Bank Address*
Phone*
CIty*
State*
Zip Code*
Bank Name
Bank Address
Phone
CIty
State
Zip Code

Contact Information
Accounts Payable Contact*
Name*
Phone*
Email*
Purchasing Contact*
Name*
Phone*
Email*

Signatures
Requested Signature*
Printed Name*
Title*
Date*
MM slash DD slash YYYY
Witness Signature*
Printed Name*
Title*
Date*
MM slash DD slash YYYY
Agreement*
- By submitting this application, you confirm you are authorized to act on behalf of your company and authorize Coolgear Inc. to make inquiries into the references that you have supplied.
- All invoices are to be paid within the established Net Terms agreement from the date of the invoice.
- Claims arising from invoices must be made within 24-48hours of receipt.
- A 5% interest charge will be applied to any outstanding balance greater than 30 days past the due date.
- You authorize Coolgear Inc. to charge your credit card the full outstanding balance (plus a 5% processing fee) for any charges that are not paid within 45 days of the due date.
- Minimum purchase for Net Terms is $1000.
Note: Please return completed form and a copy of your company’s W-9 (Taxpayer Identification Number) to [email protected] Processing may take up to 15 business days to complete.
Thank you for your patience.

Authorization for Credit Check
I hereby authorize the obtaining of “credit reports” and/or “investigative consumer reports” concerning*
To this end, I hereby authorize, without reservation, the banking institution(s) and business references provided by*
and/or information service bureau, to furnish all credit information requested by <strong>Coolgear, Inc., 5120 110th Avenue N., Clearwater, FL 33760; Phone:727-209-1300; Fax: 727-209-1302</strong>; www.coolgear.com. I confirm that I am authorized to act on behalf of*
andagree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.
Signature*
Printed Name*
Title*
Date*
MM slash DD slash YYYY

Attachment
W9 Form*
Drop files here or

Max. file size: 50 MB, Max. files: 1.
Please download from here
Company Reference Sheet
(Optional)
Drop files here or

Max. file size: 50 MB, Max. files: 1.

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A leading manufacturer of innovative USB hubs, chargers, serial devices, add-on cards, adapters and cables.

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5120 110th Avenue North
Clearwater, Florida 33760 U.S.A.

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Local: 1 727 209 1300
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