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Parts and Service: Net Due Upon Receipt
New Equipment: Net 30 Days
If you are tax exempt in Maryland, Virginia, or D.C., please attach tax-exempt certificates below
Accounts over 30 days old will be charged a service charge of 2% per month. Any additional collection expense and any legal fees incurred in the collection process will be charged to the account and due upon receipt of invoice. Invoices that extend beyond terms will be subject to credit card payment or check payment over the phone.
NOTE: If equipment start-up is required before Net 30 Day terms, full payment is required two days prior to the scheduled start-up.
If you are unable to submit the form below, please print the form here and email the completed form to firstname.lastname@example.org or fax to 301-682-3391.
STH Account Representative (Listed on Quote):*
—Please choose an option—Ben CarmackCameron HallockEvan AndersonMatt WagnerWayne EmerickRob HaydenJoseph DavisKelli SwiftKyle GroveMark BarrickCarroll HolmesAlex ReyesBrandon TylerLes PrandiService Department
—Please choose an option—AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
Type of Business:*
Name of Owner or Company President:*
Federal Tax ID #:*
Accounting Contact Name:*
Accounting Contact Phone:*
Accounting Contact Email:*
Email Address to Send Invoices:*
Accounting Fax #:
Please attach any additional forms here:
By completing this form I acknowledge that I have read & accepted all of the above terms & conditions.