Credit Application – Buchanan Dam

Business Information

Legal Business Name(Required)

DBA / Trade Name

(if applicable)

Billing Address Line 1(Required)

Billing Address Line 2

Billing City(Required)

Billing State(Required)

Billing ZIP(Required)

Shipping Address Line 1

(if different from billing)

Shipping Address Line 2

Shipping City

Shipping State

Shipping ZIP

Business Phone(Required)

Website

Entity Type(Required)

Sole Proprietorship

Partnership

LLC

Corporation

Nonprofit

Government / School

Other

Entity Type — Please Specify

Federal Tax ID / EIN(Required)

Years in Business(Required)

Ownership / Principal Information

Owner / Principal Name(Required)

Title(Required)

Owner Phone(Required)

Owner Email(Required)

Accounts Payable Contact

AP Contact Name(Required)

AP Contact Title

AP Email(Required)

AP Phone(Required)

Invoice Email Address

(if different from AP email)

Order / Billing Information

Do you require a purchase order number for invoicing?(Required)

Yes

Preferred Payment Method(Required)

ACH

Check

Wire

Credit Card

Do you claim tax-exempt status?(Required)

Yes

Upload Exemption or Resale Certificate

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.

Accepted: PDF, JPG, PNG (max 10MB)

Requested Credit Information

Estimated Annual Spend with BDSPE(Required)

Typical Order Size(Required)

Trade References

Please provide at least two complete trade references.

Expected Ordering Frequency(Required)

Trade Reference 1 — Company Name(Required)

Trade Reference 1 — Contact Name(Required)

Trade Reference 1 — Phone(Required)

Trade Reference 1 — Email(Required)

Trade Reference 2 — Company Name(Required)

Trade Reference 2 — Contact Name(Required)

Trade Reference 2 — Phone(Required)

Trade Reference 2 — Email(Required)

Trade Reference 3 — Company Name

(optional)

Trade Reference 3 — Contact Name

Trade Reference 3 — Phone

Trade Reference 3 — Email

Bank Reference

Bank Name(Required)

Bank Contact Name

Bank Phone

Applicant Acknowledgements

By signing below, Applicant acknowledges and agrees that:

The information provided in this application is true and complete to the best of Applicant's knowledge.
BDSPE may verify references and review Applicant's creditworthiness as part of the credit approval process.
Approval of credit terms is at BDSPE's sole discretion.
BDSPE may change, suspend, or revoke credit terms at any time based on payment history, account standing, order size, risk, or other business considerations.
Net 30 terms, if approved, do not waive any deposit requirements that BDSPE may impose under its policies.
Overdue balances may result in loss of terms privileges, hold on current or future orders, deposit-required status, or prepay status.
Returned payment fees, chargebacks, failed ACH transactions, and similar payment-reversal charges may be passed through to Applicant.
Late charges, finance charges, collection costs, and related remedies may apply as stated in BDSPE's applicable terms, invoices, and policies.

Applicant Acknowledgement(Required)

I certify that the information provided is true and complete and I agree to the acknowledgements above.

Authorized Signer Name(Required)

Signer Title(Required)

Electronic Signature Confirmation(Required)

I confirm that my typed name above is my electronic signature and I am authorized to sign on behalf of this business.

By checking this box, I confirm my typed name above serves as my electronic signature.

Date(Required)

BDSPE Credit Application

Business Information

Ownership / Principal Information

Accounts Payable Contact

Order / Billing Information

Requested Credit Information

Trade References

Bank Reference

Applicant Acknowledgements

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