New Account Setup

Main Contact

Contact Name*

Email*

Phone*

Business Name and Address

Business Name*

DBA (if applicable)

MC Number

Address

City

State

Zip

Ownership and Business Structure

Choose the business legal structure

Corporation

LLC

LLP

Sole Proprietor

Partnership

Non-Profit

Federal Tax ID Number

Duns Number

Principal Officer/Owner and Title

Trade Reference

Company

Contact

Phone #

City

St

Company

Contact

Phone #

City

St

Company

Contact

Phone #

City

St

Contact Information

Accounts Payable Contact Name*

Email*

Address*

City*

State*

Zip*

Phone*

Fax

Terms and Conditions

The undersigned agrees to the following on behalf of the Applicant and also represents that the undersigned is authorized by the Applicant to sign and not on behalf of the Applicant. All of the following provisions are hereby agreed to by the Applicant for him/her and assignee. The applicant agrees that the Terms and Conditions are binding upon any transaction contemplated herein. The undersigned agrees to be personally liable for any unpaid debts of the Applicant. Applicants hereby authorize the creditor to obtain credit information from any source and authorize any source to provide creditor with all credit information requests. Applicant agrees that all invoices received from the creditor are due thirty (30) days from date of each respective invoice, unless agreed to otherwise in writing by both creditor and Applicant. Applicant hereby agrees that all of the creditors’ invoices shall be payable in Warren, Michigan. Payment of invoices shall be made within thirty (30) days of the invoice date. All amounts not paid within sixty (60) days shall be subject to an interest rate of 1.5% per month. North American Specialized Transport Corp. reserves the right to pursue the shipper or consignees for unpaid charges. In the event the applicant fails to pay an invoice within sixty (60) days after the invoice date, interest shall accrue from that date, at the option of creditor, at the lesser of 18% per annum or the maximum allowed by law. In the event any third parties are employed to collect any outstanding monies owed by said business, the undersigned agrees to pay reasonable collection costs, including attorney(s) fee, whether or not litigation has commenced, and all costs of litigation incurred.

All payments shall be remitted to North American Specialized Transport Corp. at the following address:
24663 Mound Rd
Warren, MI 48091

Disclaimer*

By typing my name below, I certify that I am an authorized representative of the applicant company and that all information provided in this credit application is true, complete, and accurate to the best of my knowledge. I understand that this information is being provided for the purpose of establishing commercial credit with North American Specialized and authorize North American Specialized to verify the information provided, including contacting trade references, financial institutions, and credit reporting agencies. I agree that typed entry of my name below constitutes my electronic signature and is legally binding, carrying the same force and effect as a handwritten signature. The applicant agrees to pay all invoices according to agreed payment terms and acknowledges that past-due balances may be subject to service charges and/or collection costs, including reasonable attorney fees, as permitted by law.

Print Name*

Date*

HP Name

Main Contact

Business Name and Address

Ownership and Business Structure

Trade Reference

Contact Information

Terms and Conditions

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