Credit Application

† The owner of the property/facility is the applicant (the "Applicant") under this Credit Agreement and is the primary obligor hereunder.


Billing Contact


Please select how you receive invoices:


Shipping Contact


INFORMATION ABOUT THE PROPERTY

Management Co. represents and warrants that it is acting as appointed agent of the Applicant.


Who is authorized to place orders on this account?



           


           

Applicant represents and warrants that any products containing CFCs or HCFCs (including R22 and R410A) will be handled by a technician with a valid EPA Certificate (and in Miami-Dade, a DERM Permit). Please attach a copy of the relevant certificates and permits and identify the name(s) of this/these technician(s):


Signature

Applicant hereby agrees to the attached Terms & Conditions. To Sign, full out your full name and title below: