Please complete the form below or download the application here and email to Invoice@SurfaceCreationsVT.com
Company Name *
Showroom Street Address *
City *
State *
Zipcode *
Billing Street Address (If different)
City
State
Zipcode
Email Address *
Phone Number *
Company Officers * Purchasing Agents *
Bank Name *
Contact Name *
Branch Location *
Please list two trade references
Company *
Client Since *
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I hereby authorize Surface Creations of Vermont to investigate the references listed above in regards to our credit and financial responsibility. I certify that our company is financially able to meet any commitments we have made and we will pay all invoices according to established terms. I also acknowledge that any invoice not paid within those terms will be subject to finance charges of 1.5% per month. I have read and understand the above information and certify that my answers are true and complete to the best of my knowledge.
Signature (Printed Name) *
Date *
