CORPORATE CHARGE ACCOUNT APPLICATION

Please allow 5 business days to process your Corporate Account Application.

COMPANY INFORMATION

Company:

Address:

Suite/Floor:

Zip:

Telephone:

Fax:

Type of Bus.

Contact Person:

# of Years in Business:

# of Employees:

D&B #:

Federal Tax I.D.  or S.S. #:

Email:

BILLS TO THE ATTENTION OF:

Principal’s Name:

Telephone:

BANK REFERENCE

Bank:

Account #:
Contact Person:
Telephone:

 TRADE REFERENCE

Company:

Phone:

Fax:

 

BILLING INFORMATION (Check one): Visa Mastercard AMEX

All monthly charges will automatically be billed to credit card 10 days after statement date

Account Number:

Exp. Date:
Name on card:
Billing address:

Names of Authorized Users for the Corporate Account:

Principal’s Signature:                                                                                                      

Please Send A Copy Of Your Credit Card (Front & Back) With This Application.

 

ALL INVOICES ARE MAILED TO THE APPLICANT, UNLESS YOU INDICATE OTHERWISE.

 

General Terms and Conditions and Personal Guarantee

1.    You will be assigned a Corporate Charge Account Number.  Please give that number to your Telephone Sales Representative each time you place an order.

2.    A standard gratuity of 7% is added to all Corporate Charge Account orders for catering events over 15 people, unless otherwise stated.

3.    You will be billed once monthly. Payment is required within 10 days of receipt of invoice.  Applicant authorizes BLINKS DELI to charge the credit card supplied herein for all balances not paid in full within 10 days of invoice.  Notices of late payment will be sent prior to any charges.

4.    BLINKS DELI reserves the right to cancel your account if the above conditions are not met.

5.    BLINKS DELI Corporate Account is not valid for retail store purchase, unless arrangements have been made.

 

I represent that the above information is true and is given to induce to extend credit

to the applicant.  My company and I authorize to make such credit investigation as sees

fit, including contacting the above trade references and banks and obtaining credit

reports.  My company and I authorize all trade references, banks and credit reporting agencies to disclose to any and all information concerning the financial and credit

history of my company and myself.   I understand a full payment of our monthly

statement is due upon receipt, and that over due balances will be subject to finance

charges. The undersigned personally guarantees full and prompt payment for all charges.

 I HAVE READ THE TERMS AND CONDITIONS STATED BELOW AND AGREE TO ALL OF THOSE TERMS AND CONDITIONS.

 

AUTHORIZED SIGNATURE:                                                                                                           

TITLE:
DATE: