Form must be submitted by owner or officer of your company. All required fields are marked with ‘*’. Company Information Company Name * Also Know As (or DBA) Logistics Plus Sales Representative Tax ID * Owner, CEO or Principal * Person Completing Form Email Address * Phone Number * Fax Number Company Website Business Address Address * City * State/Province * ZIP/Postal Code * Billing Address Same As Business Address Billing Address Billing City Billing State/Province Billing ZIP/Postal Code Accounting Dept. Contact Contact Name * Email Addresss * Phone Number * Fax Number Accounts Payable Contact Same as Accounting Department Contact Contact Name Email Address Phone Number Fax Number Trade References Trade Reference Name #1 * ----Phone #1 * ----Fax or Email #1 * Trade Reference Name #2 * ----Phone #2 * ----Fax or Email #2 * Bank References Bank Reference Name #1 * ----Phone #1 * ----Fax or Email #1 * Bank Reference Name #2 * ----Phone #2 * ----Fax or Email #2 Extra Special Requirements to Process Invoices for Payments Term of Payment/Statement Logistics Plus Inc. typical customer "terms of payment" is Net 30 Days from date of invoice, provided the credit application is approved. Alternative terms may be offered if the application is incomplete or the applicant’s credit score does not meet Logistics Plus Inc. standards. We reserve the right to charge customers finance charges of 1.5% per month, or the highest rate permitted by law, on any past due amounts. Additionally, any costs incurred for the collection of charges beyond the "terms of payment," through litigation or independent collection resources are the sole responsibility of the customer, including reasonable attorney fees and Court costs. Should litigation be required with this account, filing will occur in the Court of Common Pleas of Erie County, Pennsylvania or in the United States District Court for the Western District of Pennsylvania and shall be subject to the Commonwealth of Pennsylvania Law. I (We) understand and agree to the above stated Terms of Payment and I (We) authorize Logistics Plus, Inc. to verify and investigate all information provided on this credit application Check this box if you agree * Your Name * Your Title * Today's Date (MM/DD/YY) * Confirmation
