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CREDIT APPLICATIONFAX: 866-791-4809E-MAIL: creditapplications@whitecap.netPH: 888-888-6087, OPTION 3, OPTION 3, OPTION 1LEGAL NAME OF CUSTOMER:EMAIL ADDRESS:PLEASE SELECT ONE: SOLE PROPRIETORSHIP PARTNERSHIP CORPORATION NON PROFIT ORG. JOINT VENTURE L.L.C.***FOR MAXIMUM CREDIT LIMIT, PLEASE ATTACH COPY OF MOST RECENT FINANCIAL STATEMENTS AND/OR BANK STATEMENT***STREET ADDRESS: CITY STATE ZIPMAILING ADDRESS: CITY STATE ZIPCOUNTY: BUSINESS PHONE: BUSINESS FAX:ARE YOU SALES TAX EXEMPT? (AN EXEMPTIONCERTIFICATION MUST BE ATTACHED)YESNOESTIMATED MONTHLYPURCHASES $TYPE OF BUSINESS (check the ONE that best describes business):RESIDENTIAL CONTRACTOR GOVERNMENTNO. OF EMPLOYEES:COMMERCIAL CONTRACTOR NON CONTRACTOR/OTHER BUSINESS START DATE:RESELLERA/P CONTACT: A/P PHONE: A/P FAX: A/P EMAIL:PURCHASING CONTACT: PURCHASING PHONE: PURCHASING FAX: PURCHASING EMAIL:PURCHASE ORDER NO. REQUIRED?YES NOFED. TAX DUN & BRADSTREETID NO.: NUMBER (DUNS #):NAME OF BRANCH FROM WHICH PURCHASES WILL BE MADE:PREDOMINANT TRADE (to be completed by Contractors ONLY, check the ONE that best describes business):DRYWALL FLAT WORK MECHANICAL/PLUMBING ROAD AND BRIDGE WATERPROOFINGELECTRICIANS FRAMING POURED WALL/FOUNDATION SPECIALTY TRADES MASONRYEXCAVATION GENERAL CONTRACTOR PRECAST TILT UP BUILDERSTRADE / BANK REFERENCESNAME: ADDRESS: ACCT #: PHONE:BANK NAME: ADDRESS: ACCT #: PHONE:PERSONAL GUARANTY(REQUIRED IF BUSINESS WAS ESTABLISHED WITHIN THE LAST THREE YEARS)To induce the extension of credit to Purchaser, Guarantor (jointly and severally, if more than one) hereby guarantees payment of all existing and future indebtedness of Purchaser to Seller,including any costs, expenses, and reasonable attorney's fees payable as a consequence of Seller's collection efforts. This personal guaranty is absolute, complete, irrevocable and continuingand it shall not be necessary for Seller to give notice to Guarantor of any extension of credit to Purchaser, any renewal thereof, any modification of the terms thereof, or Seller's arrangements withany other Guarantor. Guarantor may by written notice to Seller at its Corporate Headquarters as described above (Attn: Credit Dept.) terminate its guarantee as to any new extensions of credit toPurchaser made more than ten (10) days after such written notice, but Guarantor shall continue to be obligated in respect of any credit extended within ten (10) days after Seller's receipt of suchnotice and any credit Seller remains obligated to extend to Purchaser at the close of business on the tenth day following Seller's receipt of such notice. Guarantor agrees to provide personalfinancial information as reasonable requested by Seller.GUARANTOR 1 GUARANTOR 1 DATE: SS NO:PRINTED NAME:SIGNATURE:HOME ADDRESS:PHONE NO.:GUARANTOR 2 GUARANTOR 2 DATE: SS NO:PRINTED NAME:SIGNATURE:HOME ADDRESS:PHONE NO.:TERMS AND CONDITIONS(AUTHORIZED SIGNATURE REQUIRED)Purchaser certifies that it is solvent and capable of meeting its obligations hereunder, and that all information provided to seller (including Purchaser's attached financial statement) is true, accurateand complete. All such information has been submitted for the purpose of obtaining credit. Purchaser and each Guarantor authorize HD Supply and/or its affiliates ("Seller") to request creditreports from credit bureaus (including consumer reporting agencies) regarding their respective commercial or personal credit and otherwise to investigate their respective creditworthiness beforeextending credit now or any time in the future. Purchaser also agrees to comply with the applicable bulk sales laws. Purchaser agrees that all Terms and Conditions of Sale on the reverse side ofthis Credit Application and Personal Guaranty, as the same may be amended by written notice to Purchaser from time to time, shall apply to all sales and extensions of credit made to Purchaserby Seller.AUTHORIZEDSIGNATURE PRINTED NAME DATESELLER'S USE ONLYBRANCH MANAGER: BRANCH NAME: BRANCH #:SALESMAN:SALESMAN ID:COMMENTS:v1.0
