Seven Diamonds New Customer ApplicationCompany InformationCompany Name *Company WebsiteCompany Phone Number *Just enter digits; NO DASHES/SPACESE-mail AddressPhysical AddressAddress *City *State/Province *ZIP / Postal Code *Mailing Address Same as Physical Address? *YesNoMailing Address *Address *City *State *ZIP / Postal Code *Primary Contact InformationName *First. *LastPhone *Just enter digits; NO DASHES/SPACESEmail *Other Personnel Authorized to Place OrdersAdd Authorized Personal # 1NameFirstLastEmailPhoneJust enter digits; NO DASHES/SPACESTitleAdd Authorized Personal # 2NameFirst.LastEmailPhoneJust enter digits; NO DASHES/SPACESTitleAbout Your CompanyCompany Type *CorporationPartnershipSole ProprietorshipLLP/LLCFederal Tax ID *Contractor's License #Sales Tax Exempt? *YesNoUpload Copy of Current Sales Tax Exemption Certificate *Choose FileNo file chosenDelete uploaded fileNumber of Years in BusinessAccounts Payable Contact *First. *LastAccounts Payable Phone Number *Just enter digits; NO DASHES/SPACESAccounts Payable EmailBank ReferencesBank Name *Bank Phone *Just enter digits; NO DASHES/SPACESBank Address *Do You Require Use of Purchase Orders?YesNoTerms and ConditionsAs a consideration for the extension of credit the undersigned agree to the following terms: All charges incurred during any month are due within 30 days upon receipt of invoice. If payment is not made as specified, a service charge of 1.5% per month is authorized to be added to the amount due to Seven Diamonds, Mine, LLC. In the event it becomes necessary to place this account with an attorney for collection, the undersigned agree to pay all cost of collection, including attorney’s fees and hereby waive our privilege of being sued in the county of our residence agree the suit may be brought in Pasco County, Florida. Should Seven Diamonds, Mine, LLC. Ever, because of default, be obligated to institute any proceedings against the undersigned, we hereby waive any notice requirements. Delivery of any goods by Seven Diamonds Mine, LLC to the carrier at the shipping point shall constitute delivery to the buyer. I/WE CERTIFY THAT ALL THE INFORMATION ON THIS FORM IS CORRECT AND THAT I/WE FULLY UNDERSTAND YOUR CREDIT TERMS AND AGREE TO PROPER PAYMENT.Name/Title *Date *Individual Personal GuaranteeI hereby agree to bind myself to pay you on demand any sum which may be due to you the by Company whenever the Company shall fail to pay the same. It is understood that this guarantee shall be continuing and irrevocable guaranty and indemnity for such indebtedness of the Company. I do hereby waive notice of default, non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guaranteed.Officer/Owner Name *First. *LastOfficer/Owner TitlePlaceSocial Security# *Submit
