Shamrock Hose & Fittings.
216.531-7800
Home
Company
Manufacturers
Services
Products
Resources
Catalogs
Credit Application Form
BUSINESS CONTACT INFORMATION
Name
Title
Company Name
Phone
Email
Registered company address City, State ZIP Code
Date Business Commenced
Business Type
Sole Proprietorship
Partnership
Corporation
Other
BUSINESS/TRADE REFERENCES
1. Company name
Contact Name
Address
Phone
City, State ZIP Code
Email
Annual Spend
Length of Business Relationship
2. Company name
Contact Name
Address
Phone
City, State ZIP Code
Email
Annual Spend
Length of Business Relationship
3. Company name
Contact Name
Address
Phone
City, State ZIP Code
Email
Annual Spend
Length of Business Relationship
AGREEMENT
All invoices are to be paid 30 days from the date of the invoice.
By submitting this application, you authorize Shamrock Hose & Fittings to make inquiries into the banking and business/trade references that you have supplied.
SIGNATURE
Name & Title
Date
