Customer Application - Ark Transportation

General Business Information:

Legal Business Name:

Trade Name / DBA:

Type of Business

Date Established:

Number of Employees:

Physical Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your physical address the same as your billing address?

Yes
No

Billing Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Business Phone

Parent Company:

Does Parent Company Guarantee Debts?

Yes
No

Please Provide Details:

Federal Tax ID or SS Number:

Accounts Payable:

Phone:

Email:

Management

CEO or President:

Phone:

Email:

CFO:

Phone:

Email:

Controller:

Phone:

Email:

Credit Agreement

Do you want to apply for Credit?

Yes
No

Trade Credit References

Reference 1 Name:

Reference 1 Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Reference 1 Phone:

Reference 1 Contact:

Reference 2 Name:

Reference 2 Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Reference 2 Phone:

Reference 2 Contact:

Banking References

Bank 1 Name:

Bank 1 Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Bank 1 Phone:

Account Rep:

Bank 2 Name:

Bank 2 Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Bank 2 Phone:

Account Rep:

Credit Agreement Terms

Accept
Decline

The undersigned Firm hereby makes application for credit and provides the information contained herein and/or attached hereto, which warranted to be true and correct, for the purpose of inducing Ark Transportation, LTD., to make sales of goods and services to such Firm on terms. It is understood that this information will be held in the strictest confidence. In consideration thereof, it is agreed that the undersigned is an authorized agent of the Firm and is duly empowered to enter into and making binding agreements on its behalf. The Firm authorizes Ark Transportation, LTD., to verify with third parties any of the information concerning the Firm submitted in this application, including credit history which is information we understand that you are relying on for the purpose of granting credit. Credit may be extended on open account, not to exceed Net 30 days from the invoice date. If credit is so extended by Ark Transportation, the Firm agrees as follows: That the Firm will pay when due, according to the terms established by Ark Transportation, LTD., not to exceed Net 30 from invoice date, all invoices, statements, or any account balance due to Ark Transportation, LTD. any such payments to be made to Ark Transportation, LTD., at P.O. Box 81752, Cleveland, OH 44181-0752, or at such other place or places as Ark Transportation LTD., may direct. 1. Maintenance of Credit Privileges - Continuation of credit privileges is dependent upon maintaining account in satisfactory condition. The customer must adhere to Ark's Credit Policy Terms and Conditions. Our policy is to suspend privileges of customers who accounts are not maintained on a current basis. All past due accounts are subject to a late payment charge on the past due balance of the lesser of one and one-half percent (1.5%) per month (an annual rate of 18%) or the maximum rate permitted by law. Reasonable collection costs, including attorney fees, incurred in collecting payment for items will be charged and paid by the customer. This is in addition to any other rights we have because of the late payment. 2. All orders, including but not limited to, electronic and verbal orders are subject to Ark Transportation, LTD. terms and conditions. All orders placed with Ark Transportation LTD. shall be presumed delivered, properly billed, and received in satisfactory conditions unless proper notification has been provided and confirmed received by Ark Transportation, LTD. within ten (10) days of date the date of receipt. 3. Ark Transportation, LTD. at its sole discretion, may at any time cease further extensions of credit firm.

Signature

*All the information I provided is accurate and true at the time of signing.

Name:

First

Last

Title:

Date

I accept Ark's Customer Terms and Conditions

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Customer Login

Ark Customer Application

General Business Information:

Management

Credit Agreement

Trade Credit References

Banking References

Signature

Contact Ark

P.O. Box 81752 Cleveland, Ohio 44181