Beeline+Blue : blueprints, scanning, large format printing, display prints


PLEASE FILL OUT COMPLETELY AND SIGN TO ESTABLISH NET 30 DAY TERMS
Desired Credit Limit
COMPANY NAME:
d/b/a:
Bill to Address
Street Address
City/State
Owners(s)/President
Accts. Payable Contact
AP Phone & Fax #
AP E-mail Address
Banking Institution
Acct. Numbers
Contact
Phone & Fax #�s
Years in Business
Dunn & Bradstreet #
Annual Sales
Net Worth
Number of Employees
Federal Tax ID #
Please attach reseller�s certificate
Company Structure	Sole Proprietorship Corporation State Partnership LLC
T R A D E R E F E R E N C E S
NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:
I authorize the release of the above information to Beeline+Blue for credit purposes only.� In order for Beeline+Blue to grant me credit, I give permission for my credit to be checked as required for that purpose.� Credit terms are net thirty (30) days from the date of invoice.� Interest will be charged at 1.5% per month on items over thirty (30) days.� If my account is referred for collection, I agree to pay all billing and collection costs and a reasonable attorney�s fee.� All the above is true and terms are accepted.
Print Officer�s Name
Officer�s Signature
Officer�s Title
Date	Thursday, August 21, 2008