Payment Terms Application Form

Net 30 payment terms are offered to approved medium and large companies and government agencies

Conex Depot Order #

Company or Agency Name *

Company or Agency Website / URL *

Years in Business *

Main Company or Agency Address *

Address Line 1

Address Line 2

City

State

Zip Code

Shipping Container(s) Delivery Address (if different to Company/Agency Address)

Address Line 1

Address Line 2

City

State

Zip Code

Your Name *

First

Last

Position *

Phone *

Email *

Accounts Payable Contact Person *

First

Last

This person is responsible for payment of the account

Accounts Payable Phone *

Accounts Payable Email *

Purchase Order File Upload

Click or drag files to this area to upload. You can upload up to 2 files.

A signed purchase order issued by your company/agency must be submitted with all credit applications. Payee is: Conex Depot Inc, 187 E Warm Springs Rd Suite B237, Las Vegas, NV 89119, United States. You can upload it now, or email it later to sales@conexdepot.com

Signature *

I hereby certify that the information provided herein is complete and accurate. Payment Terms: Conex Depot Inc offers payment terms of net 30 calendar days from the date of product delivery to approved companies and government agencies. If approved for credit the company shown above agrees to make full payment for the product(s) and delivery fees outlined in the order invoice within the agreed payment term. Late fees of 5% per month are automatically applied to accounts that are 14 days past due. By signing and submitting this form you agree that as an authorized signatory of the company or agency listed above you agree to pay late fees and (if necessary) debt recovery and legal fees associated with past due accounts.

Name *

Date *

Payment Terms Application Form

Net 30 payment terms are offered to approved medium and large companies and government agencies

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