WATER TREATMENT WAREHOUSE, INC. CREDIT APPLICATION
726 Commerce Dr., #107 Venice, FL 34292 941-488-3346 Fax 941-488-7594


Firm Name:_______________________________________________ dba/_________________________

Billing Address:____________________________________________ Phone: ______________________

City: __________________________ State:_______ Zip: ___________ Fax: ______________________

Ship To Address:____________________________________________ Phone: ______________________

City: __________________________ State:_______ Zip: ___________ Fax: ______________________

Legal Entity: (__) Corporation (__) Sole Proprietorship (__) Partnership

How many years have you been in business? _______

For Florida businesses:
Will your purchases be exempt from sales tax? ___ If “YES” please send a signed copy of your current exemption certificate.
If you pay sales tax, what county are you in? ___________________________________________.

Please complete all requested information regarding Principal Owners, Stockholders and/or Officers.

Legal Name: __________________________________ Position ____________ SS# _________________

Home Address: __________________________________ City:_______________ ST _____ Zip_________

Legal Name: __________________________________ Position ____________ SS# _________________

Home Address: __________________________________ City: _______________ ST _____ Zip_________

Legal Name: __________________________________ Position ____________ SS# _________________

Home Address: __________________________________ City:_______________ ST _____ Zip_________

TRADE REFERENCES: Please include your account #, complete addresses, phone and fax numbers

1. Name: _____________________________ Address __________________________________________

Account #: __________________________ Phone #:_____________________ Fax #: _______________

2. Name: _____________________________ Address __________________________________________

Account #: __________________________ Phone #:_____________________ Fax #: _______________

3. Name: _____________________________ Address __________________________________________

Account #: __________________________ Phone #:_____________________ Fax #: _______________

Bank:_____________________________ Officer: ________________________ Phone # ______________

Account #: ____________________________


AGREEMENT TO TERMS AND CONDITIONS

 I certify that all products/materials purchased as sales tax exempt will be used for resale purposes only. I further certify that this application is for the sole purpose of obtaining credit and that all statements are true and correct. I fully understand and agree to the terms of Net 30 and that all invoices are due and payable 30 days from date of invoices and that any invoices not paid within 30 days shall be declared delinquent. I therefore agree to a service charge of 1.5% interest per month, which translates to 18% per annum from date of delinquency. I further agree to pay any and all collection fees due and payable if my account is referred to a duly licensed collection agency or if necessary, any and all attorney fees, court costs or any and all fees and charges incurred if the services of an attorney or collection agency become necessary to collect.

I also understand that Water Treatment Warehouse, Inc. reserves the right to change prices without notice. I also understand that Water Treatment Warehouse, Inc. reserves the right to change policies and terms in the future if and when necessary.

By submitting and signing this form, applicant warrants that he has read and agrees to the terms and conditions and grant permission for the above references and bank to supply credit information to Water Treatment Warehouse, Inc. and credit reports to be obtained.

By signing this form, applicant warrants that he/she has read and agrees to the terms and conditions set forth on this application package.

Signature of Applicant:__________________________________________


Please Print Name: _____________________________________________


Title:_____________________________________

Tax ID# or SS#_____________________________

Driver's License #___________________________
(Photo copy of driver's license required)


Date:______/______/______



To: Water Treatment Warehouse, Inc.
726 Commerce Dr.
Venice, Florida 34292

Re: __________________________________________________(“Customer”)

Dear Water Treatment Warehouse, Inc.:

This will confirm the understanding between us.

As an inducement to you to grant credit, or assume a credit risk, from time to time, in respect of sales of goods made by you to Customer, or in respect of any other type of transaction by which you may become Customer's creditor, the undersigned Guarantor shall pay you promptly when due, or upon demand thereafter, without deduction of any claim of set-off or counterclaim of Customer or loss of contribution from any co-guarantor, or any other defense, the full amount of all obligations or indebtedness due you from Customer, including interest, whether originating in transactions between you and Customer, or assigned or transferred to you, together with all expenses of collection and reasonable counsel fees incurred by you by reason of Customer's default.

This is a continuing guaranty, and shall be revocable only as to transactions entered into by you subsequent to the receipt by one of your officers of notice of termination sent by the undersigned by registered or certified mail.

The undersigned waives notice of acceptance hereof, and notice of orders, sales, and deliveries to Customer, and of the amounts and terms thereof, and of all defaults or disputes with Customer, and of the settlement or adjustment of such defaults or disputes. The undersigned, without affecting his or her liability hereunder in any respect, consents to and waives notice of all changes of terms, the withdrawal or extension of credit or time to pay, the release of the whole or any part of the indebtedness, the settlement or compromise of notes, trade acceptances, or any other form of obligation for Customer's indebtedness, and the demand, protest, and notice of protest of such instruments of their endorsements. The undersigned also consents to and waives notice of any arrangements or settlements made in or out of court in the event of receivership, liquidation, readjustment, bankruptcy, reorganization, arrangement, or assignment for the benefit of Customer's creditors, and anything whatsoever, regardless of whether herein specified, which may be done or waived by or between you and Customer, or Customer and many other person whose claims against Customer have been or shall be assigned or transferred to you.

The obligation of the undersigned is a primary and unconditional obligation, and covers all of Customer's existing and future indebtedness to you. This obligation shall be enforceable before or after proceeding against Customer or against any security held by you, and shall be effective regardless of Customer's solvency or insolvency at any time, the extension or modification of Customer's indebtedness by operation of law, the subsequent incorporation, reorganization, merger, or consolidation of Customer, or any other change in Customer's composition, ownership, nature personnel, or location.

All liabilities of Customer and of the undersigned shall mature immediately upon the Customer's insolvency, it inability to meet its obligations as they become due, the appointment of a receiver, custodian or trustee for Customer or any of its property, the filing of a voluntary or involuntary petition for relief in bankruptcy, reorganization, or arrangement, the making of an assignment for the benefit of creditors, or the calling of a meeting of creditors by Customer, or if any of the foregoing events occur with respect to the undersigned.


Nothing herein contained shall be construed as an obligation on your part to sell goods or extend credit to Customer, or to continue to sell goods or extend credit. Your records showing the account between you and Customer shall be admissible in evidence in any action or proceeding involving this Guaranty, and such records shall be prima facie proof of the items therein set forth. This Guaranty shall for all purposes be deemed to be made in, and shall be governed by and construed in accordance with the laws of, the State of Florida.

This Guaranty shall be binding upon the undersigned, his or her legal representatives and assigns, and shall inure to your benefit and that of your successors and assigns.

Yours very truly,

SIGNATURE_______________________________________________, Guarantor


PLEASE PRINT NAME _______________________________________________________

TITLE_______________________________________________________________________