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Equipment Request
About 9Bar
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Equipment For Sale
Cart
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Equipment Request
About 9Bar
Services
Equipment For Sale
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New Customer
application
New Customer Application and Credit Authorization
Business Name
*
DBA (Company Name)
Primary Contact
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Website
http://
Instagram
@
Facebook
Current Coffee Provider
Type of Business
*
Cafe
Restaurant
Grocery
Office
Other
Entity Type
*
Corporation
LLC
Partnership
Sole Proprietor
Other
In Business Since
*
If you have not yet opened please enter your projected opening date.
MM
DD
YYYY
Federal Tax ID Number
*
State Resale Number
*
Service Location
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Billing Address
Additional service addresses
*
Please list one per line:
Yes
No
Scheduling Contact
*
First Name
Last Name
Scheduling Contact Phone Number
*
(###)
###
####
Scheduling Contact Email Address
*
Accounts Payable Contact
*
First Name
Last Name
Accounts Payable Phone Number
*
(###)
###
####
Accounts Payable Email Address
*
Type of Equipment to be Serviced
*
Include Make/ Model/ Serial #
Description of Trouble
Service work is billed materials plus labor and travel, unless a quote has been provided and approved by customer. Standard travel charge of $95/hour will apply to all service calls. Remote service locations will be evaluated on a case by case basis. All service and travel charges are billed one hour minimum each. Regular rates: $106/hour Overtime rates apply weekdays after 5pm, weekends, and holidays $142.50/hour As consideration for the extension of credit, by clicking Submit above, applicant agrees to: (1) Credit terms of Net 7 from date of invoice. Net 15 will be extended to customers whose payments have been made within Net 7 aftera 90-day grace period. (2) In the event it becomes necessary for 9 Bar Tech Co to employ a collection agency for the recovery of any debt owed by the applicant, 9 Bar Tech shall be entitled to recover, in addition to the full amount of all debts due, interest on such debts, and all costs of collection. By typing applicant’s name into signature field and clicking submit, the applicant’s representative acknowledges that overdue accounts may be subject to late fees and/or finance charges of up to 1.5% per month (18% annual percentage rate). The applicant agrees that 9 Bar Tech Co may extend, withdraw, or deny credit at any time, at 9 Bar Tech’s sole discretion. By typing my name into signature field and clicking submit, I represent that I have the authority to act on behalf of the applicant, to bind the applicant to the terms of this application, and to authorize 9 Bar Tech Co to verify the applicant’s trade information. I have the authority to order the service work outline above and agree to the above stated charges. I agree that 9 Bar Tech Co retains the title to parts and materials furnished until payment is made.
Customer Signature
*
Date of Application
*
MM
DD
YYYY
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