Credit Application - Bonded Transportation Solutions

Sales Person *

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Trade References

Enter in Trade References. (Please provide us with your trade reference sheet if available.)

Company Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Fax Number

Company Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Fax Number

Trade Reference Sheet Upload

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Bank Information

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Bank Name

Bank Address

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Address Line 2

City

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Zip Code

Account Number

Federal Tax ID Number

Dun & Bradstreet Number

Billing Requirements

Enter in your Billing Requirements

Our terms are NET 15 DAYS; does your accounts payable meet these terms?

If NO, what terms will your accounts payable meet?

Do you require a PO#, BOL#, Ref#, etc? Yes or NO If yes, please specify

List any other specific billing requirements

Are you interested in online shipping/tracking? Yes or No

Are you interested in e-mail POD's? Yes or No

Contact

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Please check off all of the services you have a need for, or are interested in

Local Delivery
Lease Drivers
Out of State
Small Vehicle
Lift Gate
Scheduled
Hazmat
Tractor-Trailer
On-Call
24' Straight Truck
Distribution
Air Freight
Inter-Office
Daily Mail
Warehousing

Current Vendor

Past Concerns

Terms & Conditions

Applicant understands the terms and conditions, including credit terms of 15 days, for utilizing services with Bonded Transportation Solutions, Inc. Should applicant fail to pay within said 15 day period, applicant agrees to pay a 1.5% per month finance/service charge on the unpaid balance. In the event payment is not made and account, at the sole discretion of Bonded Transportation Solutions, Inc., is referred for collections, then applicant agrees to pay all costs associated with the collection efforts, including but not limited to, reasonable attorney's fees and court costs together with interest thereon at a rate of 1.5% per month.

Check if you agree to the Terms & Conditions (Required) *

I Accept

Signed *

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Date *

Date

Time

Credit Applications

Company Information

Trade References

Bank Information

Billing Requirements

Terms & Conditions