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Smyrna Ready Mix Concrete
1136 Second Avenue North
Nashville, TN 37208

APPLICATION FOR BUSINESS CREDIT

Please answer all questions. When a question isn’t applicable, write n/a or none.

Date of Application: 2/22/2018

SECTION 1 - APPLICANT

Applicant / Customer Name:
P.O. Box
Address: Street

City

State

Zip
Telephone Number:
Fax Number:
Email:
Payment Responsibility / Contact Name:

SECTION 2 - BUSINESS DESCRIPTION

Business Type:
Description of Business:
How Long in Business:
Parent Company:
Dun & Bradstreet Number:
Address: Street

City

State

Zip
Telephone Number:

SECTION 3 - OFFICER(S), PARTNER(S), PROPRIETOR, OWNER, MEMBER INFORMATION

Person 1: Name

Title
Person 2: Name

Title
Person 3: Name

Title

SECTION 4 - CREDIT REFERENCES

Bank Reference: Name

Account Number

Address

Phone Number

Fax Number
Credit Reference 1: Name

Account Number

Address

Phone Number

Fax Number
Credit Reference 2: Name
Account Number

Address

Phone Number

Fax Number
Credit Reference 3: Name
Account Number

Address

Phone Number

Fax Number
Credit Reference 4: Name
Account Number

Address

Phone Number

Fax Number

SECTION 5 - MISC INFORMATION

Federal ID Number:
Purchase Order Numbers Required:
Bonding Company:
Bonding Company Address: Street

City

State

Zip
Estimated Monthly Credit Requirements:
State Contractors License Number:
Tax Status:
Include tax exempt certificate
Have you ever filed for bankruptcy?
If yes, give data and reason

SECTION 6 - TERMS AND CONDITIONS OF BUSINESS CREDIT

This Application, including all of the information contained herein, is a request for one or more extensions of business credit to defer payment for purchase of construction materials by Applicant from Smyrna Ready Mix, LLC. By submitting this Application to Smyrna Ready Mix, LLC, Applicant hereby agrees to these Terms and Conditions.

Applicant hereby agrees to pay Smyrna Ready Mix, LLC for each purchase made hereunder, as follows: (Net 30) Applicant agrees to pay Smyrna Ready Mix, LLC a monthly late charge equal to the lesser of 1.5% or the maximum amount permitted by State Law. Applicant agrees that each individual sale shall be subject to these Terms and Conditions, the terms and conditions set forth in Smyrna Ready Mix, LLC quotation, including the General Terms and Conditions which form a part thereof, and, if applicable, any terms and conditions relating to the delivery or shipment of construction materials by truck which are provided by Smyrna Ready Mix, LLC to Applicant.

Applicant authorizes Smyrna Ready Mix, LLC from time to time to obtain one or more credit reports from any reporting agency and to obtain information regarding Applicant from any creditor of Applicant, including, but not limited to, each of the credit references listed in Section IV. Applicant further authorizes each of the creditors to give to Smyrna Ready Mix, LLC from time to time any and all necessary information that will aid Smyrna Ready Mix, LLC in its credit investigation. Applicant further authorizes Smyrna Ready Mix, LLC to reinvestigate credit status from time to time as Smyrna Ready Mix, LLC deems necessary. Smyrna Ready Mix, LLC reserves the right to limit, terminate, or change the terms of any extension of credit to Applicant at its sole discretion. Applicant authorizes Smyrna Ready Mix, LLC to act as a credit reference for Applicant by responding to inquiries from other creditors or potential creditors of Applicant regarding transactions or experiences with Applicant.

Each of the undersigned does hereby certify that he/she is authorized to sign this Application on behalf of Applicant; that the information contained herein is true, accurate, and complete in all respects; and that all purchases made by Applicant will be made in the ordinary course of business of Applicant for business purposes and that no credit is sought or will be obtained for the personal, family, or household purposes of any individual. Applicant will advise Smyrna Ready Mix, LLC in writing at the address referenced on its invoices of any changes which occur in respect to any of the information included in this Application (including, but not limited to, any of the information provided in Section II or III) or any other information which may affect ability to pay, and until such time, Smyrna Ready Mix, LLC may continue to rely on this information. Any changes in legal status or the information provided in Section II or III must be communicated at least five business days in advance by certified mail. The original Applicant will remain liable until such time as Smyrna Ready Mix. LLC has been given a reasonable period of time to respond to any notice regarding changes in legal status. Applicant further agrees that these Terms and Conditions are governed by the laws of the state where the shipments originated and that if any provision hereof is held invalid, illegal or unenforceable, then no other provision shall be affected or impaired thereby.

Applicant will pay all costs of collection, including, but not limited to, attorneys fees equal to the greater of 25% of the amount of the outstanding indebtedness, or the maximum allowable under state law, should all or any part of this account be placed for collection. Applicant further waives the right to a jury trial in the event Smyrna Ready Mix, LLC is required to institute suit for collection of any sums due hereunder. Applicant agrees that any and all claims arising out of or relating to any sale or extension of credit by Smyrna Ready Mix, LLC, including, but not limited to, any action by Smyrna Ready Mix, LLC to collect on account, may be filed in Federal or State court where the shipments originated, and Applicant specifically consents to the exercise of non-exclusive personal jurisdiction over Applicant by a Federal or State court where the shipments originated, and to extraterritorial service of process, if necessary.

Applicant agrees that any claims concerning quality control, or compliance with product specifications, shall be waived unless written notice of such claim shall be delivered to Smyrna Ready Mix, LLC, by certified mail at the address found on its invoice, within 30 days of receipt of such products by Applicant.

Smyrna Ready Mix, LLC may at any time, assign its right for payment hereunder.

Person 1: Name

Title
Person 2: Name

Title

SECTION 7 - PERSONAL GUARANTY OF BUSINESS CREDIT

For value received, each of the undersigned hereby personally and individually guarantees payment when due of all indebtedness now due or which may become due by Applicant to Smyrna Ready Mix, LLC even though from time to time there may be no indebtedness owing by Applicant. To the maximum extent allowed by applicable state law, this personal guaranty is unlimited in amount and shall apply to all balances arising from sales to Applicant under the above Terms and Conditions for twenty years after the date immediately below. Each of the undersigned waives all notices with respect to this guaranty and waives acceptance of this guaranty by Smyrna Ready Mix, LLC.

Each of the undersigned hereby subordinates any indebtedness owed to the undersigned by Applicant and any right of subrogation or contribution against Applicant or any other guarantor until all indebtedness has been paid and satisfied in full. Each of the undersigned agrees to pay all costs of collection, including, but not limited to, attorneys fees equal to 25% of the amount of the outstanding indebtedness, after default by the undersigned hereunder. Each of the undersigned authorizes Smyrna Ready Mix, LLC to check the undersigned's credit and employment history from time to time and to obtain one or more consumer reports regarding the undersigned.

Date: 2/22/2018
Person 1: Name

Social Security Number
Person 2: Name

Social Security Number