Credit application - General Rentals Corp.

Company Name:

Mailing Address: Street Address:

City: State: Zip:

Phone: Fax:

E-Mail address:

Type of business: Corporation Partnership Individual

Please list officers names and their titles:

Please list 3 trade references:

1. Name Address: Phone:

2. Name Address: Phone:

3. Name Address: Phone:

How long have you been in business?

What type of business is yours?

Are purchase order numbers required? Yes No

Are job numbers required? Yes No

Is your firm tax exempt? Yes No (if yes, please send an exemption certificate)

Accounts Payable contact person:

Persons authorized to use account:

Please note: General Rentals terms are net 30 days from statement date.