Credit Application

Thank you for choosing Commonwealth Equipment Corporation for all your Crushing and Screening needs! Payment Terms: Net 30 days for parts and service Accounts over 60 days become COD until made current Equipment Rentals are due at start of each rental Downtime must be reported IMMEDIATELY to Faithe Buzza Payment Methods: Checks may be mailed to the address below. We also accept all major credit cards! Tax Status: We collect and remit sales tax in Pennsylvania, Maryland, Virginia, West Virginia, and North Carolina. Tax Exempt Certificates must be received at the time of purchase, or invoiced sales tax is due and payable unless a certificate is received within 30 days of the invoice date. Contact Information: Toll Free: 877-217-4474 Equipment Sales and Rentals - Ext 1 Parts Dept. - Ext 2 Service Dept. – Andy Powell – Ext 3 Billing & Downtime – Faithe Buzza – Ext 401 Accounts and Payments – Brandon Gerhat – Ext 415 Commonwealth Equipment Corporation 36 Hazleton Street Ashley, PA 18706

Applicant Information

Will you be doing business with Commonwealth Equipment under any other name?

Please send my invoices to the address below

Please ship my order to the address below

Primary company phone number

Please provide your company's Tax ID

Type of Account Requested*

Will you be renting equipment, or buying parts/service?

Estimated Monthly Purchases

Business Type*
Tax Status*

Will you be exempt from sales tax on purchases from Commonwealth Equipment?

Please upload a copy of your W-9, and tax exempt certificate (if applicable).

Drag and drop files here or

Officer Details

Please provide information about a corporate officer, who is authorizing purchases from Commonwealth Equipment.

Purchasing Info

Accounts Payable Info

Trade References

Please provide contact information for three trade references.

Disclosure

The information on this form is submitted for the purpose of opening a credit account or qualifying for financing. I do hereby certify this information is true and correct to the best of my knowledge. By the digital signature of the applicant (officer, principal, owner, or partner), I hereby authorize Commonwealth Equipment to run a full investigation of my credit history including, but not limited to, obtaining a consumer credit report. I acknowledge I have read, and agree to comply with, the payment terms listed above. I understand late fees of 1.5% per month will be applied to any overdue balances along with reasonable collections and attorney fees, if applicable.

Name

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