CREDIT APPLICATION

Fax No. 770-819-5540

Yancey Bros. Co.
P.O. Box 43326
Atlanta, GA 30336-0326
Customer Number Assigned
Date Accepted
Branch

 Limit
Date Declined
CREDIT DEPT. USE ONLY
Date
Firm Name
 Business Location
Mailing Address
 City
 State
 Zip
Phone
 Partnership Individual Proprietorship
Corporation Other
Federal ID# /
Soc. Sec. No.
 Are Purchase
Orders Req?
YesNo		 Sales Tax Exemption No
State
 Certificate of Exemption Req

Office Mgr or Accountant


 Yr. Established /
Incorporated
State Incorporated
O
W
N
E
R
S
H
I
P		 Name Complete Address & Zip Soc. Sec. #
Owner / Pres.
Partner / Officer
Partner / Officer
Partner / Officer




Banks (Include personal bank if proprietorship or partnership)
R
E
F
E
R
E
N
C
E
S		 Name Address Account # Phone Officer
To Contact
Equipment Dealers And Other Suppliers (Open Accounts)
Name Address Account # Phone #Yrs Done Bus. Amount Avg. Mo.
List Caterpillar - Built and Comparable
Equipment Now Owned		 Clear or Obligated To
(Name & Account)
Additional Information
Future Work: Please provide details of customer contracts related to this application and also attach a listing of other contracts in progress or awarded.
Project Name Location Duration Value
Insurance & Bonding Information (Contractors Only)
Bonding Company Name & Address (City, State/Prov., Zip)

 Telephone

Insurance Company Name
Policy No.
 Exp. Date
Coverage

Agent Name & Address
Telephone

 


TERMS AND CONDITIONS OF CREDIT FROM YANCEY BROS. CO.

1. This application is submitted by the undersigned (hereinafter referred to as "applicant") for the purpose of obtaining a credit account with YANCEY BROS. CO. Under penalty of law, all representations are accurate, complete and truthful to the best of the applicant's knowledge and belief.

2. The Applicant hereby authorizes any individual, firm or corporation given as credit reference to disclose to YANCEY BROS. CO., orally or in writing, any information which is pertinent to this application.

3. If the Applicant is a corporation, the undersigned affirmatively states that he is authorized to make application on behalf of said corporation and to obligate same for any credit extended thereto as a result of this application; and further that the corporation on whose behalf application is hereby made will continue to be bound and obligated for any credit advanced thereto until notice to the contrary is given in writing to YANCEY BROS. CO. at the ADDRESS SHOWN ON THE FRONT OF THIS APPLICATION.

4. If applicant presents a Financial Statement as a part of this application, it will be attached hereto and made a part hereof. Applicant agrees to submit Financial Statements as requested by YANCEY BROS. CO. Any Financial Statements submitted in connection with this application or as requested by YANCEY BROS. CO. will be accurate and truthful. These will be held in strict confidence.

5. Credit extended by YANCEY BROS. CO. to Applicant shall be due on the terms as shown on each invoice rendered to applicant for each purchase. Applicant agrees to pay the amount when due to avoid a FINANCE CHARGE. If Applicant's account becomes past due, it will be subject to a FINANCE CHARGE at the rate of 1 1/2% per month on the outstanding amount. It is expressly understood by Applicant that the existence of the FINANCE CHARGE does not affect Applicant's obligation to pay the account in full when due.

6. If, after delinquency, Applicant's account is referred to an attorney for collection, Applicant agrees to pay reasonable charges incurred by YANCEY BROS. CO., including reasonable attorney's fee and court costs.

7. NOTICE TO APPLICANT - DO NOT SIGN THIS AGREEMENT UNTIL YOU HAVE READ IT. YOU ARE ENTITLED TO A COPY OF THIS SIGNED AGREEMENT.

8. In consideration of the extension of account privileges, I (we) agree to be bound by the terms and conditions stated above and acknowledge receipt of a copy of this application.

Signed: ______________________________(Title) Date: ________________________

Signed: ______________________________(Title)


GUARANTY
FOR VALUE RECEIVED, the undersigned does guarantee payment of all amounts advanced by YANCEY BROS. CO., to Applicant if Applicant defaults in its payment of any such indebtedness. The undersigned shall also pay to YANCEY BROS. CO., all reasonable costs of collection, including a reasonable attorney's fee and court costs. This is an unconditional and continuing guaranty of payment and shall remain in full force until the undersigned delivers to YANCEY BROS. CO., written notice revoking it as to indebtedness incurred subsequent to such delivery. The undersigned waives notice of acceptance, of presentment, demand, protest, notice of non-payment or protest and agrees this guaranty shall be binding upon the heirs, personal representatives, successors, and assigns of the undersigned.

Signed: __________________________________ Date: _________________________

Guarantor: ____________________________________