CHESAPEAKE
PERFORMANCE INC.
(410) 758-2575
Fax (410) 758-2912
Company Name: _______________________________________
Company Phone #______________________________Fax#____________________________
Print Name of Person completing form:
____________________________________________
Type of Organization: _______Corporation _______Partnership
_______Proprietorship
Federal Tax ID #
______________________ State Sales
Tax ID _____________________
Names of Owners/Principals of the Business:
Name/Title
Email
Address
Internet
address_______________________________________________________________
Mailing
Address of Business: ______________________________________________
______________________________________________
______________________________________________
Shipping
Address of Business: ______________________________________________
______________________________________________
______________________________________________
Trade References: (list at least three)
Banking Information:
Name/Branch: __________________________________________________________
Address __________________________________________________________
Telephone
# __________________________ Fax #
_________________________
Account
Type: ____________________________
Account #: ____________________________
The normal terms of Chesapeake
Performance Inc. are Net 30 days. In the
event your application is not approved before shipment, terms will be COD.
I acknowledge and agree that a
finance charge of 1-1/2% per month will be charged on all balances remaining
unpaid after 30 days from the date accounts are incurred. This is an annual percentage rate of 18%
The undersigned agrees to assume
any liability incurred by the above named company and is in agreement that
payment will be made strictly according to the terms set forth herein. In the
event of default, the guarantor agrees to pay interest as stated herein
together with costs of court and reasonable attorney’s fees. Payments are to be made to
Chesapeake Performance Inc. according to this agreement.
The undersigned agrees to the terms and conditions of an open account with
Chesapeake
Performance Inc..
Company Representative:
______________________________________________
Signature & Title:
______________________________________________
Please fax back completed
form to Mike Schmidt
at 410-758-2912. If you have any questions regarding the
completion of this form, please contact Mike Schmidt at
410-758-2575 or by e-mail at
mike@cpimetals.com Thank you.