Credit Application - Transit Mix

Account Information

Date *

Account Number

Salesman

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Business Credit

Business Name *

Address *

Street

Address City *

City

Address State *

State

Address Zip *

Zip

Phone *

Cell

Fax

Industry

Years in Business

Business Type

Accounts Payable Contact

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Principals/Guarantors

1) Name

Title

Home Address

Street

Address City

City

Address State

State

Address Zip

Zip

SS#

Phone Number

2) Name

Title

Home Address

Street

Address City

City

Address State

State

Address Zip

Zip

SS#

Phone Number

3) Name

Title

Home Address

Street

Address City

City

Address State

State

Address Zip

Zip

SS#

Phone Number

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Financial References

Bank (Checking)

Bank Address

Street

Address City

City

Address State

State

Address Zip

Zip

Checking Account Number

Bank Phone Number

Bank (Construction)

Bank Officer

Officer Phone Number

Current Loans

Previous Loans

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Major Supplier References

Name

City

Phone Number

Fax Number

Name

City

Phone Number

Fax Number

Name

City

Phone Number

Fax Number

Name

City

Phone Number

Fax Number

Do You Require Purchase Orders

Tax Exemption?

Attach File

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Terms of Open Account

All accounts are due and payable on or before the 10th day of the month following purchase date. Accounts not paid in accordance with these terms will be subject to closing and/or FINANCE CHARGE of 1.25 % (15% APR) compounded annually.

I/we hereby certify that the foregoing statements are true and correct and are made for the purpose of securing credit and authorize Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc. to obtain any further information they may require. I/we understand that inaccurate information or omissions may cause denial in case of bankruptcy. I/we understand and agree that in the event of default in the payment of any credit extended, my/our obligation may be referred to an attorney or collection agency and I/we shall pay reasonable attorney's fees and all costs of collection.

To be filled out by an officer if a corporation, Manager if an LLC

Firm Name

Officer's Name

Officer's Title

Officer Signature

Date

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PERSONAL GUARANTY

Required if a Corporation, LLC, LLP, LLLP

Guarantor, in consideration for inducing Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc. to extend credit to the applicant, the receipt and sufficiency of which is hereby acknowledged, and further acknowledging that Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc. intend to rely on the guarantee of Guarantor, does personally and unconditionally guarantee to pay any and all sums now or therefore owed to Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc. for materials, labor, or rental items supplied at the request of the applicant or it's agents or employees, together with interest at the rate of 1.25% (15% APR) compounded annually.

Liability of the guarantor is direct, irrevocable, unconditional and independent of that of the Customer and may be enforced without requiring Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc. first to exercise, enforce, or exhaust, any remedy against the applicant.

The guarantor for himself and the Applicant agrees to pay all costs and Attorney's fees should this matter be referred to an attorney or other collection agency upon default. The guarantor also agrees to submit to the jurisdiction of Colorado courts and exclusive venue in El Paso County, Colorado.

Any revocation of this Personal Guaranty shall be effective only as to credit extended after the date of factual receipt of a written notice sent by certified mail, return receipt requested to Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc.

The obligation of Guarantor under this Personal Guaranty will bind the benefits the heirs, executors, administrators, legal representatives, successors, and assigns of Guarantor and Transit Mix and/or Castle Concrete Co. and/or Daniels Sand and/or Transit Mix of Pueblo, Inc.

First Guarantor

Name Print

Signature

Name Sign

Date

Second Guarantor

Name Print

Signature

Name Sign

Date

Print Form

End Section