Online Credit Application -Central Mass Party Rentals and Equipment

ONLINE CREDIT APPLICATION

Please complete the below form. You may submit
your information to our credit department via this online form - or you can print this page from your browser and mail it to one of the addresses at the bottom of this page.

Company Name:

Street Address:
City:	State: Zip:

Organization Type:

Corporation Sole Proprietorship Partnership

FEIN/SSN:

Phone:

Fax:

E-mail:

Nature Of Business:

Years In Business:

Desired Credit Limit:

Corporate President:

Name:

Home Address:

Home Phone:

E-mail:

Corporate Vice President:

Name:

Home Address:

Home Phone:

E-mail:

Accounts Payable:

Name:

Phone:

E-mail:

Please List Those Who Are Authorized To Pick Up Equipment:

Do You Require Purchase Order Numbers? Yes No

For damage waiver exemptions - please send a certificate of insurance with Central Mass Party Rentals and Equipment as the certificate holder.

Are You Tax Exempt? Yes No
(if yes, please send a copy of your certificate)

Please List Trade References:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Bank Information:

Bank Name:

Bank Address:

Contact Person At Bank:

Bank Phone:

A finance charge of 1 1/2% of the unpaid invoice will be assessed at 30 days.

I, hereby certify to the above statements and agree to abide by the credit terms set forth by Central Mass Party Rentals and Equipment.

Date:

Prices do not include Tax or D.W.C. (damage waiver coverage)

Central Mass Party Rentals and Equipment

(800) 281 - TENT
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Worcester North
124 West Boylston Street
Worcester, MA 01606

(508) 853-5383

Central Mass Party Rentals & Equipment

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