Credit Application Credit Application We would like to thank you for your business. We truly appreciate it and hope that we will have a long and successful association for our mutual benefit. We feel a full understanding of terms and responsibilities is required for any business relationship. In promotion of that goal, we want you to be aware of our policies and terms as follows: Bills are due and payable in full, within 10 days of the date of billing. Any and all statements not paid prior to next end of month billing will have a 1% per month penalty added. If an attorney or collection service must be hired to collect unpaid balances, you will be responsible for their fees and all court costs. Also, you will personally assume responsibility for this account, if a Corporation goes out of business. If you have any questions, please feel free to call me anytime. If you agree to the aforementioned, please sign where indicated showing that you understand our billing terms and policies and will abide by them. Sincerely, Mike Wenzel President Ralph’s General Rent-All, Inc. 1390 S. Eastwood Drive Woodstock, IL 60098 Phone: 815-338-3101 Fax: 815-338-6910 I fully understand and agree to the above stated billing terms and policies. Name: * Title: * Phone Number: * City: * State: * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: * Name (as account will be carried): * Business Type: * At Present Location Since: * Year Established: * Please select: * Corporation Individual LLC Partnership DBA Names and Titles of Officers How many company officers? * 1 2 3 4 5 6 7 8 9 10 Officers Officer Name 1: * Officer TItle 1: * Officer Name 2: * Officer Title 2: * Officer Name 3: * Officer TItle 3: * Officer Name 4: * Officer TItle 4: * Officer Name 5: * Officer TItle 5: * Officer Name 6: * Officer TItle 6: * Officer Name 7: * Officer TItle 7: * Officer Name 8: * Officer TItle 8: * Officer Name 9: * Officer TItle 9: * Officer Name 10: * Officer TItle 10: * Bank References Principle Depository Bank: * Bank City: * Bank State: * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Bank Zip: * Business References (Give only names of those you buy from on open account) How many references ? * 3 4 5 6 7 8 9 10 Business References Reference Info 1: * Reference Phone 1: * Reference Info 2: * Reference Phone 2: * Reference Info 3: * Reference Phone 3: * Reference Info 4: * Reference Phone 4: * Reference Info 5: * Reference Phone 5: * Reference Info 6: * Reference Phone 6: * Reference Info 7: * Reference Phone 7: * Reference Info 8: * Reference Phone 8: * Reference Info 9: * Reference Phone 9: * Reference Info 10: * Reference Phone 10: * Our Rental Contract provides that the customer renting equipment is responsible to Ralph’s General Rent-All Inc. for any loss or damage to the equipment and for its return in the same condition in which received, normal wear and tear excepted. The customer’s responsibility for accidental damage, can be waived by accepting the Damage Waiver Option (DWO) at a cost of 12% of the total rental fee of each contract. Excluded from this DWO is any damage due to theft, burglary, abuse, theft by conversion, intentional damage and mysterious disappearance. The DWO does not cover damage to tires and tubes caused by blowouts, bruises, cuts, punctures or other causes inherent in the use of equipment. The customer is still required to take reasonable precautions against damage and to properly maintain the equipment while in their possession, including securing equipment properly when being transported, adequate and proper servicing of equipment such as lubrication and prevention from freezing. It would not cover equipment if the damage results from violation of the terms of our rental contract or use not permitted by law or damage resulting from overloading, exceeding rate capacities, misuse or abuse. The renter is responsible for any and all damage. In addition, if the renter has insurance for damage to rented equipment, the renter shall himself exercise, and shall empower Ralph’s General Rent-All, Inc. to exercise, all rights available to the renter to obtain recovery under insurance, shall cooperate with Ralph’s to obtain recover and all insurance proceeds shall be given or assigned to Ralph’s. Signature: * Clear reCAPTCHA If you are human, leave this field blank.