Credit Application

Nu-Tech appreciates the opportunity to supply you with our products and equipment. In order to avoid delays in shipments or the need to ship products C.O.D., Nu-Tech will extend terms of net 30 days to qualified customers. If you wish to open a 30-day account, simply complete this application. Until approval is received, all purchases will be shipped C.O.D., VISA/MC/Discover. Shipments made C.O.D. to you are not an inconvenience to us, we are just making Open Credit available to you.

YOUR COMPANY NAME *

ACCOUNTS PAYABLE EMAIL *

ADDRESS

Address Line 1

Address Line 2

City

State

Zip Code

TYPE OF BUSINESS *

YEAR ESTABLISHED *

TAX EXEMPT #

FEIN # *

RESALE # (PLEASE FURNISH COPY OF CERT) *

D-U-N-S # *

OWNER/OFFICER INFO: *

NAME *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

PHONE *

FAX

Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

PHONE

FAX

YEARS UNDER CURRENT MANAGEMENT

TRADE REFERENCES (COMPANIES THAT EXTEND YOU NET TERMS)

COMPANY

ACCOUNT #

Address

Address Line 1

Address Line 2

City

State

Zip Code

COMPANY

ACCOUNT #

Address

Address Line 1

Address Line 2

City

State

Zip Code

COMPANY

ACCOUNT #

Address

Address Line 1

Address Line 2

City

State

Zip Code

BANK REFERENCE:

NAME

ACCOUNT #

CONTACT:

Address

Address Line 1

Address Line 2

City

State

Zip Code

I hereby certify that I am duly authorized to make this application and allow verification of the above information. I guarantee payment of all bills when due, and acknowledge a delinquency
assessment at the maximum allowable interest rate by law until paid; and in the event the account is placed with an attorney for collection or suit of the same is collected through probate or
bankruptcy proceedings, then an additional reasonable amount shall be added to the same as attorney’s fees. It is understood and agreed that any checks returned to us by your bank shall
be charged a service fee; that any account with an N.S.F. check shall be placed on a C.O.D. cash only basis for a probationary period and determined by the Credit Department. This guarantee
shall be continuing, absolute and unconditional, and shall remain in full force and effect until written notice of its discontinuance is sent by cer tified or registered mail, return receipt
requested an dactually received by Nu-Tech and until any and all indebtedness existing before receipt of such notice shall be fully paid.

Agree? *

Name *

First

Last

Date / Time

Date

Time

Credit Application

CREDIT APPLICATION

TRADE REFERENCES (COMPANIES THAT EXTEND YOU NET TERMS)

BANK REFERENCE:

Nu-Tech Satisfaction Guarantee

SIGN UP FOR E-CLEAN NEWS AND GET

$25 OFF

YOUR PURCHASE OF $100 OR MORE!

USE CODE 30YEARS TO GET

$25 OFF

YOUR PURCHASE OF $100 OR MORE!