In consideration of being extended credit, we agree to the below terms and conditions:
1. Full payment is due within 30 days after shipment per invoice date. Past due accounts are subject to a service charge equal to 1.5% per month (but in no event higher than permitted by law in the state where obligation is payable). Accounts 60 days or more past due are financially responsible for all reasonable cost of collection, including attorney’s fees. Laws of the State of Indiana apply. Any action required to collect payment will be instituted in the County of Hendricks, State of Indiana. Signature of this document supersedes any special payment terms listed on purchase orders.
2. We hereby authorize each of the supplied trade and bank references to release to you confidential information about us concerning payment and credit history.
Authorized Signature: __________________________________________________
Above Signature Typed: __________________________________________________
Title: __________________________________________________
Date: __________________________________________________
Company Name and Address: __________________________________________________
Phone Number: __________________________________________________
Fax Number: __________________________________________________
Fax Number – Accounts Payable: __________________________________________________
County of Business: __________________________________________________
**THIS FORM MUST BE COMPLETED**
