El Camino Credit Application Form

Application For Credit
For the purpose of establishing credit with El Camino Rental, the undersigned applicant furnishes the following information and authorizes El Camino Rental to verify credit worthiness with references listed below. Application represents and warrants said information is true and correct, and a complete statement of company information and financial condition.
 
 
 
Business Name
 
Date
 
 
Business Type
 
Year Established
 
 
Physical Address
Mailing Address
 
Primary Office Number
 
Fax Number
 
Mobile Number
 
 
Contractors License Number:
 
Employer Tax I.D. Number (EIN):
 
 
Owner One (Name (Last, First, Middle initial), title, address, telephone)
 
Social Security Number
 
Date of Birth
 
CDL Number
 
 
Owner Two (Name (Last, First, Middle initial), title, address, telephone)
 
Social Security Number
 
Date of Birth
 
CDL Number
 
Accounting Contact Info (Name (Last, First, Middle initial), telephone, email)
 
Bank References (Name, Address, Telephone)
Account Number
 
 
Trade Reference (Name & Address)
 
Trade Reference (Telephone)
 
Account Number
 
Fax
 
Trade Reference (Name & Address)
 
Trade Reference (Telephone)
 
Account Number
 
Fax
 
Trade Reference (Name & Address)
 
Trade Reference (Telephone)
 
Account Number
 
Fax
 
 
Do you require a purchase order number on each contract?
 
 
 
 
 
 
 
 
Do you have any restrictions on who can order or sign for equipment?
 
 
 
 
 
 
 
 
If you have restrictions on who can sign, please provide a list of authorized personnel here.
 
Request to receive invoice and/or statements via:
 
USPS, Fax, Email Address For Invoices
 
Terms & Conditions
We/ I agree to abide by the terms and conditions of the rental contract and to pay all charges incurred within 10 days of billing. It is agreed that payments not made within 30 days of the billing date will be charged 1.5% (18% APR) service charge, computed from the billing date, and any additional purchases will be on C.O.D. basis. We also agree that in the event of default on payment or any other terms or conditions of the rental contract to pay all collection costs in the collection thereof as determined by the court, inclusive attorney fees, court costs etc. It is agreed that in the event of a returned check by our/my bank we/I will be charged a $35.00 fee each.

Must be signed by company/corporate officer.
 
Signature
 
Title
 
Date
 
Personal Guaranty
In consideration of the extension of credit by the seller, herein to buyer herein the undersigned does jointly and severally personally guaranty to pay and be responsible for payment of all sums, balances, and accounts due seller by buyer including collection charges and attorney fees. This shall be an open and continuing guaranty and shall continue in force notwithstanding any changes in the form of such indebtedness, or renewals or extensions granted by seller, without obtaining any consent thereto and until expressly revoked by written notice from me/us to seller. Any such revocation shall not in any manner affect my/our liability as to any indebtedness existing prior thereto. I/we do hereby waive notice of the acceptance of the agreement, notice of default or non-payment and waive action required by a statute against the buyer. No delay on sellers part in exercising any right hereunder, or taking any action to collect or enforce payment of any obligation hereby granted, either as against the buyer or any other person primarily or secondarily liable with the buyer shall operate as a waiver of any such right or in any manner prejudiced sellers rights against me/us. I/We agree that in the event of any time by said buyer, seller shall be entitled to look in me/us immediately for full payment without prior demand or notice.
 
 
 
Signature
 
Title
 
Date
 
E-mail form to s.fowler@elcaminorental.com
-or -
Fax form to 760-722-7821

5701 El Camino Real ~ Carlsbad, Ca 92008
Phone: 866-736-8327 Or 760-438-7368 Fax: 760-438-2575
Other Locations: Oceanside And Vista