COMPANY DIRECTOR/OFFICER/PRINCIPAL INFORMATION
Name of Company Principal/Owner Responsible for Business Transactions
BUSINESS CONTACT INFORMATION
Primary Contact Information
Legal Contact Information
Accounts Payable Contact Information
(Please provide at least one (1) reference from our industry)
SPECIAL BILLING INSTRUCTIONS
BILL TO LOCATIONS
ADDITIONAL BILL TO LOCATIONS
By submitting this credit application/agreement, the individual executing this Application below on behalf of the customer, individually and personally, represents and warrants to Qualawash Holdings, LLC that:
1. He/She is authorized to execute this Application on behalf of the customer
2. The information set forth in this Application is accurate and complete
3. Any legal action brought by the Customer will be in the jurisdiction of Hillsborough County, Florida, and the Customer hereby submits to the jurisdiction of said courts. The laws of the State of Florida will apply.
Payment and Invoicing
Payment for all services rendered are due 30 days from the invoice date. Invoices will be sent via E-mail, and can also be accessed via our Customer Portal. Any item disputed, must be done so by giving written notice within 30 days from the invoice date. Failure to initiate a dispute on a particular invoice in this timeframe will waive your right to dispute that invoice . All disputes must be sent to QHL-Disputes@qualawash.com. A dispute on a particular invoice does not waive your right to withhold payment on non-disputed invoices. Per the terms and conditions laid out here, those must be paid within 30 days from invoice date. The customer agrees to pay all costs of collection or legal fees should such action be necessary due to non-payment.
Failure to pay invoices in a timely manner may result in your account being placed on Credit Hold. Credit Hold may happen as early as 45 days from the invoice date. If your account is placed on Credit Hold, Qualawash Holdings, LLC will not perform any new services until your account is brought in good standing. Should your account continue to remain past due, the account may be placed in default. Default status may happen as early as 60 days from the invoice date. Should your account be placed in default, you will have 15 days to cure your default. Failure to cure the default may then result in termination. At which time your account may be forwarded over to Legal for further actions.
Tax Exemption Status
If your Company is exempt from State Sales Tax, it is your responsibility to provide a valid exemption certificate at the time of this application or at such time when you become eligible for exemption. Upon receipt of a valid certificate, Qualawash Holdings, LLC will perform the necessary tasks to establish tax exemption to the account. All taxes invoiced prior to receipt of a valid exemption certificate must be paid in full to Qualawash Holdings, LLC.
Finance Charges and Non Sufficient Funds (NSF)
Qualawash Holdings, LLC reserves the right to assess finance charges of 1% per month (12% per annum) on all invoices that are past due. Customers with past due amounts will receive a finance charge invoice each month. Finance charges will be assessed as of the end of the month and reduced by any amounts in dispute and any payments received by monthend but not posted.
Customer agrees to pay $50 for each check issued by the customer to Qualawash Holdings, LLC which is returned to Qualawash Holdings, LLC unpaid or marked NSF.
In submitting this Application, customer agrees to all of the above and hereby grants permission for credit information to be verified by company(ies) and financial institition(s) that the Customer has specified on this document and others that Qualawash Holdings, LLC becomes aware of during the credit reveiw process and from time to time. If the applicant is not a Corporation, Qualawash Holdings, LLC is authorized to obtain credit reports on the proprietors, partners, or principals. The undersigned also understands that Qualawash Holdings, LLC will retain this Application, whether or not it is approved, and that Qualawash Holdings, LLC will consider this Application as a continuing statement of the undersigned's financial position and situation until notified otherwise by the Customer.
In order for Qualawash Holdings, LLC to sell and continue to sell to the Customer, Customer hereby represents and warrants that it is solvent and that it pays its obligations as they become due. The preceding representation and warranty will be deemed to be repeated in each purchase by the Customer. Faxed documents will be deemed as original. No oral agreements will be accepted. The terms on this credit application/agreement overrides all others.