Credit Application

Main Office

P. O. Box 2163 / 4034 Altizer Avenue
Huntington, WV 25722 / 25705
Phone: (304) 523-3484
Fax: (304) 523-0510

Lexington, KY

740 Enterprise Drive
Lexington, KY 40510
Phone: (859) 255-0852
Fax: (859) 259-1171

Bridgeport, WV

4938 Benedum Drive
Bridgeport, WV 26330
Phone: (304) 592-3884
Fax: (304) 592-5779

Bowling Green, KY

140B Ambassador Drive
Bowling Green, KY 42101
Phone: (270) 843-0852
Fax: (270) 780-9894

Nashville, TN

3333 Hydes Ferry Road
Nashville, TN 37218
Phone: (615) 254-3484
Fax: (615) 770-9999

Hebron, KY

1639 Youell Road
Hebron, KY 41048
Phone: (859) 525-8080
Fax: (859) 282-3843

South Charleston, WV

117 D Street
South Charleston, WV 25303
Phone: (304) 744-3484

Fax: (304) 744-3510

This application must be completed in its entirety before being submitted. Thank you.

Step 1 of 4

OPEN CURRENT CHARGE ACCOUNTS

Do not use banks, utilities, or credit card companies. Must add minimum of three credit references.

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Fax

ALL SALES WILL BE SUBJECT TO THE FOLLOWING TERMS

RETURN MATERIAL: When orders have been filled as specified, no goods may be returned by purchaser, nor will any credit be allowed, unless written consent has first been obtained from a representative of CITCO Water (hereinafter referred to as the company). When so obtained , the Company’s present policy, subject to change further without notice, is to accept returned material if it, in their sole discretion, shall be the invoice price less twenty (20) percent on accepted material, less all shipping and handling charges. In all other cases, the credit, as determined by the Company shall be the scrap value of the goods, less shipping and handling charges.

MANUFACTURER’S WARRANTY: Goods sold by the Company that are covered by a manufacturer’s warranty are covered only to the extent of the manufacturer’s warranty. This manufacturer’s warranty, which is given expressly and in lieu of all other warranties, expressed or implied, of merchantability and fitness for particular purpose, constitutes the only warranty made by the companies.

TRUST FUND AND JOB BILLING: The Company’s policy is to rely upon the trust fund provisions of Federal and State laws requiring that contractors receiving payments on jobs use such funds to pay their suppliers. The Company will, therefore, require information identifying each job so that separate bills can be rendered for each project.

SERVICE CHARGE: A service charge of 1-1/2% per month (18% per year) will be billed to your account on all invoices thirty (30) days past due.

TERMS OF PAYMENT: Terms are net thirty (30) days from invoice date. The Company reserves the right to demand payment in full with all accrued service charges at any time after the first service charge has accrued. Purchaser agrees to pay Company’s reasonable attorney’s fees together with all costs and disbursements incurred if the account is placed with an attorney for collection.

The undersigned understands that the information provided in this application is being submitted for the purpose of obtaining credit from the Company and hereby authorizes the Company or their representatives to utilize this document as authority and written consent to obtain credit history from third parties. If the Purchaser utilizes the Company for a credit reference, the Purchaser hereby authorizes and consents to the Company providing said information to any third party as requested.

The undersigned thoroughly and completely understands and agrees to the above terms and conditions of credit with the Company in the event of credit acceptance.

Date(Required)

Name of Customer(Required)

First Last

Signature(Required)

Title(Required)

PERSONAL GUARANTEE

Applicant:

In consideration of your selling materials and merchandise to your company, the undersigned individual personally guarantees to you, your successors and assigns, the prompt payment of all sums as and when due from the above named company, without first requiring you to proceed against said company and the undersigned personally guarantees payment of all subsequent purchases by said company from you, as well as any and all obligations previously incurred by said company.

I waive all notices including notice of acceptance hereof and of defaults in payment and agree that my personal liability shall not be impaired by any extension of the time or other indulgence to any obligor or by any exchange or substitution of goods.

I agree to pay the reasonable attorney’s fees; costs and disbursements incurred by CITCO Water. in the event that you retain an attorney to enforce this agreement.

THIS IS A CONTINUING PERSONAL AGREEMENT. Any changes or modifications including substitutions of guarantor or the termination of the guarantor’s obligations under this agreement can only be obtained by the written consent of CITCO Water.

Guarantor (Signature without title)(Required)

SSN

Date

Add Guarantor?

Yes

Guarantor

I have received a true copy of this guarantee.

Main Office

Lexington, KY

Bridgeport, WV

Bowling Green, KY

Nashville, TN

Hebron, KY

South Charleston, WV

PRINCIPAL OWNER(S) OR OFFICERS

OPEN CURRENT CHARGE ACCOUNTS

ALL SALES WILL BE SUBJECT TO THE FOLLOWING TERMS

PERSONAL GUARANTEE

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