Coffee Surf Co Customer Application

Coffee Surf Co Customer Application

Applicant Information

Name
Name
First Name
Last Name

Company Information

Address
Address
City
State/Province
Zip/Postal
Same as Location Address
Company Contact Information
Company Contact Information
City
State/Province
Zip/Postal

Company Representive

Name of person representing the company
Name of person representing the company
First Name
Last Name

Bank Reference

Trade References

Credit Card Information

Card Billing Adress
Card Billing Adress
City
State/Province
Zip/Postal
Card Number
Card Number

Business Credit Terms for Coffee/Non-Equipment Purchases

By proceeding with this application, you acknowledge and accept the following: Payment is due within 7 days of the invoice date for the first three orders. Payment terms will extend after the first three orders to 30 days from the invoice date. A late fee of 1.8% may be incurred if payment is not received within 30 days. If any invoices remain unpaid for more than 60 days, the credit card on file may be charged for the full amount due, including any late fees, to bring the account current.