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Required

Creditor Name

Credit Limit

Commercial Credit Application

Application Must Be Completely Filled Out

To open an account a signed application must be submitted to Utica Rent-All.
Print this form and complete all the required information. Mail To:
Utica Rent-All, 43961 Van Dyke Ave., Utica, MI 48317.
Or Fax To: (586)731-7530

Business Name______________________________________

Business Address____________________________________

Billing Address____________________________________

Phone (______) ____________

FAX (______) _______________

Indicate Business Form: Check One.

( ___ ) Individual or D/B/A. Provide name, personal residence address, telephone #, and Social Security number.

( ___ ) Partnership. Provide name, personal residence address, telephone number, and Social Security number for each general partner.

( ___ ) Corporation or Limited Liability Company. Provide name of each member officer and office held, personal residence address and telephone, FED I.D. # _______________.

_________________________________________________________________________

In Business Since: ___________________________

Business Description: _________________________________________________________

__________________________________________________________________________

Banking Affiliation:

Name of Bank: _______________________________

Contact Person _______________________________

Branch Address _______________________________________________________

Account #'s ____________________________________

10.

Credit Sources:

11.

Commercial Trade References (Please include a rental store if possible. Do not list personal references, retail charge accounts or credit sources listed in item 10 above.)

			Required
	Name	Address	Phone	FAX
a.
b.
c.

12.

Are you tax exempt? ( ___ ) YES ( ___ ) NO

If you claim exemption from State Sales Tax, please indicate on what basis. If yes include copy of Tax Exemption Certificate with this application.

( ___ ) Industrial Processing ( ___ ) Other (Please explain and document)

____________________________________________________________________________

13.

Persons authorized to pick up rental property, and special instructions: (or attach letter).

__________________________________________________________________

14.

Do you require written purchase orders? ( ___ ) YES ( ___ ) NO

If YES, attach a copy. Also, identify person(s) authorized to sign: (Print or Type Name).

__________________________________________________________________

15.

Credit Terms and Conditions:

UTICA RENT ALL, INC., ("Utica") reserves the right to extend credit or refuse to extend credit to the Applicant at any time. The Applicant agrees that if Utica extends credit to the Applicant with respect to any transaction, the Applicant shall remit full payment for the amount of credit so extended within 10 day after the date stated on the invoice for that transaction. Applicant agrees that it will pay Utica interest at the rate of 1.25 % per month of any sum not paid with that 10 day time period. Applicant also agrees to pay any and all costs of collection incurred by Utica in connection with any credit extended to the Applicant, including Utica's actual attorney fees. Any dispute concerning any credit extended by Utica shall be resolved in the Utica District Court or the Macomb County Circuit Court, which ever may be applicable.

Applicant acknowledges that this Credit Application is being furnished for the purpose of inducing Utica to extend credit to the Applicant from time to time. The undersigned, on behalf of the Applicant and the undersigned: (a) Represents that the information contained in this document is true and correct; (b) Represents that the undersigned has authority to execute and cause the Applicant to enter into the agreement provided in this document; (c) Represents that any transaction for which Utica extends credit hereunder is in connection with the business activities described in Section 8 above; (d) Agrees that Utica may make credit inquires concerning the Applicant to any person, including any credit reporting agency or any reference listed in Sections 10 and 11 above, and further, that any such agency or reference may disclose to Utica any credit, financial and other information herein, including the terms of payment.

Date: ________________________

Applicant Name: _____________________________

Signature of Authorized Representative: _______________________________

Please Print Authorized Representative's Name: ________________________________

PERSONAL GUARANTY (For All Corporations and Limited Liability Companies):

The undersigned hereby guaranty(ies) the full and complete payment of any and all sums due from Applicant to Utica pursuant to the terms of this document. All of the undersigned agree that the undersigned is (are) primarily liable on such sums, and that Utica may proceed directly against any of the undersigned, either individually or collectively, without regard to whether Utica proceeds against the Applicant. The venue previsions recited above shall also apply to this guaranty.

Date:______________		Signature: ________________________________________

		Print Name _______________________________________

Date:______________		Signature: ________________________________________

		Print Name _______________________________________

NOTICE: The provisions of this document constitute the entire agreement of the parties.