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TFI HealthCare Credit Application
Fill in the form and click the Submit button. Bold fields are required.
Company Name:
Contact Name:
Address:
Address 2:
City:
State:
Zipcode:
Phone:
Fax:
Company Type:
Tax ID:
Registered State:
Business Start Date:
Officers/Owners/Partners
Name
Title
SSN
Bank Information
Bank Name:
Branch:
Address:
City:
State:
Zip:
Phone:
Checking Acct#:
Savings Acct #:
Terms of Sale
All charges are payable according to the terms contained on invoice. Applicant hereby agrees to pay interest at
the rate of 1.5% per month on all balances that are thirty days past due. As to all goods sold, Tubular
Fabricators Industry Inc. makes no express or implied warranty of merchandise or fitness for a particular
purpose.
Our liability shall be limited to either the replacement of any defective goods or a refund of its purchase.
In no case shall we be liable for incidental or consequential damages.
If applicant does not pay Tubular Fabricators Industry, Inc. in the full amount of any charges by its due date, or if
applicant fails to meet any other obligations under this credit application, or if the credit privileges hereunder are
misused or used fraudulently, or if any representation in the information regarding your financial affairs you provide
us for this account proves to be false, or you become the subject of any bankruptcy or similar proceeding, Tubular
Fabricators Industry, Inc. without advanced notice, can close your account and declare the entire account balance
payable immediately. If this happens, applicant agrees to make immediate full payment.
Applicant hereby (a) represents that the information contained herein is true and correct (b) agrees to the terms of
sale ( c) agrees to pay all costs of collection including attorney's fees if applicants account is not paid when due.
This credit application and rights, responsibilities of the applicant hereunder shall be governed by and construed
in accordance with the laws of the Commonwealth of Virginia. The applicant hereby irrevocably waives any
and all right to a trial by jury in any legal proceeding arising out of or related to this credit application
or any other document or transaction contemplated hereby. Any legal action or proceeding with respect
to this credit application or any other document or transaction related hereto may be brought in the
City of Petersburg, Commonwealth of Virginia or of the United States for the Eastern district of Virginia,
and, by execution and delivery of this credit application, the applicant and each guarantor hereby
irrevocably accepts for itself respect of its property, generally and unconditionally the jurisdiction of the
Aforesaid courts. Both Customer and Tubular Fabricators Industry, Inc. agree that this Application has
been submitted on an electronic basis by Customer and, if accepted by Tubular Fabricators Industry, Inc.
on the electronic basis, shall constitute an enforceable Credit agreement.
ELECTRONIC SIGNATURE OF AUTHORIZED CUSTOMER OFFICER-First Name:
ELECTRONIC SIGNATURE OF AUTHORIZED CUSTOMER OFFICER-Last Name:
Title of Authorized Customer Officer:
Date of Customer Application:
Guarantee:
For valuable consideration and in exchange for Tubular Fabricators Industry, Inc. from time to time
making credit available to the Applicant, each of the undersigned hereby jointly and severally
guarantee payment to us without offset or deduction the full amount of such credit extension as and
when the same shall become due, plus all interest, costs, expenses and attorney's fees. This is a
guarantee of payment. Each of the undersigned agrees (a) that this Guarantee is absolute and
unconditional, (b) that each guarantor waives all rights of subrogation and all homestead exemptions
as to the debt guaranteed, (c) that acceptance of this guarantee is waived, (d) that we can deal with the
applicant in any way we deem appropriate without releasing our guarantee, and ( e) that this Guarantee
is binding upon you and your estate.
This credit application and rights, responsibilities of the applicant hereunder shall be governed by and
construed in accordance with the laws of the Commonwealth of Virginia. The applicant hereby
irrevocably waives any and all right to a trial by jury in any legal proceeding arising out of or
related to this credit application or any other document or transaction completed hereby. Any legal
action or proceeding with respect to this application or any other document or transaction related
hereto may be brought in the City of Petersburg, Commonwealth of Virginia or of the
United States for the Eastern District of Virginia, and, by execution and delivery of this credit
application, the applicant and each guarantor hereby irrevocably accepts for itself and in
respect of its property, generally and unconditionally the jurisdiction of the Aforesaid courts. Both Customer
and Tubular Fabricators Industry, Inc. agree that this Application has been submitted on an electronic basis
by Customer and, if accepted by Tubular Fabricators Industry, Inc. on the electronic basis, shall constitute
an enforceable Credit agreement.
ELECTRONIC SIGNATURE OF GUARANTOR (1)-First Name:
ELECTRONIC SIGNATURE OF GUARANTOR (1)-Last Name:
Personal Street Address:
City:
State:
Zip:
DATE OF GUARANTOR (1) ELECTRONIC SIGNATURE:
ELECTRONIC SIGNATURE OF GUARANTOR (2)-First Name:
ELECTRONIC SIGNATURE OF GUARANTOR (2)-Last Name:
Personal Street Address:
City:
State:
Zip:
DATE OF GUARANTOR (2) ELECTRONIC SIGNATURE:
Application Authorization:
The applicant hereby authorizes it's bank, all credit agencies and all other creditors from time to
time to release information regarding its account to Tubular Fabricators Industry, Inc. Both Customer and
Tubular Fabricators Industry, Inc. agree that this Application has been submitted on an electronic basis
by Customer and, if accepted by Tubular Fabricators Industry, Inc. on the electronic basis, shall constitute
an enforceable Credit agreement.
ELECTRONIC SIGNATURE OF AUTHORIZED CUSTOMER OFFICER-First Name:
ELECTRONIC SIGNATURE OF AUTHORIZED CUSTOMER OFFICER-Last Name:
Title of Authorized Customer Officer:
Date of Customer Application:
By clicking on "Customer Agrees to Electronic Application" below, this Application will be considered as a valid
Application and will be reviewed and processed by Tubular Fabricators Industry, Inc.
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