Bulk | New Customer Company Background & Information

Please fill out the form below or download the form and email it to ar@bulkequip.com

Company Background & Information
Company Name*
Type*
Other:*
Website
Date of Business Commenced*
MM slash DD slash YYYY
Physical Address (no P.O. Boxes)*
County*
City*
State*
Zip*
Primary Contact*
Primary Contact Email*
Company Phone*
Company Fax
Accounts Payable
AP Address*
AP City*
AP State*
AP Zip*
AP Contact*
AP Contact Email*
AP Phone*
Invoices mailed or emailed?*
- Mailed
- Emailed
Will Purchase Orders be issued prior to delivery or commencement of services?*
- Yes
- No
Please provide contact name*
Business/Trade References
Reference 1
Reference 1 - Company Name*
Reference 1 - Address*
Reference 1 - City*
Reference 1 - State*
Reference 1 - Zip*
Reference 1 - Phone*
Reference 1 - Fax
Reference 1 - Type of Account*
Reference 1 - Email
Reference 2
Reference 2 - Company Name*
Reference 2 - Address*
Reference 2 - City*
Reference 2 - State*
Reference 2 - Zip*
Reference 2 - Phone*
Reference 2 - Fax
Reference 2 - Type of Account*
Reference 2 - Email
Reference 3 (Optional)
Reference 3 - Company Name
Reference 3 - Address
Reference 3 - City
Reference 3 - State
Reference 3 - Zip
Reference 3 - Phone
Reference 3 - Fax
Reference 3 - Type of Account
Reference 3 - Email
Review & Send
Sales Tax Status:*
- Taxable
- Exempt
If exempt, we must receive a valid tax exemption certificate in order for invoices to exclude taxes. The document should be sent to ar@bulkequip.com.
Name*
Title*
Bulk Equipment Corp's standard invoice terms are N30 and we expect that all invoices shall be paid timely. A monthly Finance Charge of 1.5% (18% APR) will be added to all past due amounts. Bulk reserves the right to suspend future services or shipment of goods on past due accounts. Failure to pay shall enable Bulk Equipment Corp. to collect any collection and legal costs. Venue shall be LaPorte County, Indiana. By submitting this form, you agree to these terms and authorize Bulk Equipment Corp. to make inquiries into the references supplied. Any information provided herein will be used strictly for purposes of setting up your account with us and held in confidence. These terms shall apply to any and all work requested by customer of Bulk.
Consent*
I agree to the terms stated above.*

New Customer

Company Background & Information

Accounts Payable

Business/Trade References

Reference 1

Reference 2

Reference 3 (Optional)

Review & Send

Thanks for your submission