1 CREDIT Limit Requested $_____. CREDIT APPLICATION AND AGREEMENT . FULL LEGAL NAME_____ DATE_____. MAILING ADDRESS_____. _____. PHONE_____ STATE / COUNTRY OF INCORPORATION_____. Year established _____ __ Number Of Employees _____ DUNs Number:_____. OWNERSHIP: CORPORATION PARTNERSHIP SOLE PROPRIETORSHIP. FEDERAL TAXPAYER NUMBER (OR SOCIAL SECURITY NUMBER) _____. BILLING INFORMATION. BILLING ADDRESS _____. ACCOUNTS PAYABLE CONTACT_____ PHONE _____. ACCOUNTS PAYABLE EMAIL ADDRESS _____. PRIMARY AP CONTACT OR PAYING AGENT_____. OTHER BUSINESS NAMES USED _____. NAMES OF SUBSIDIARIES / AFFILIATES_____. BANK INFORMATION. PRIMARY BANK NAME_____ CONTACT_____. PHONE_____ ACCOUNT(S) ADDRESS_____. TRADE REFERENCES. COMPANY NAME_____ PHONE_____. ADDRESS_____ CREDIT LIMIT_____.
2 FAX _____ EMAIL ADDRESS_____. COMPANY NAME_____ PHONE_____. ADDRESS_____ CREDIT LIMIT_____. FAX _____ EMAIL ADDRESS_____. IF OCEAN TRANSPORTATION INTERMEDIARY ("OTI"), FMC LICENSE #: _____ _____. IF OTI, SPECIFY: OTI/freight forwarder OTI/NVOCC OTI/freight forwarder & NVOCC. If OTI/NVOCC, show where tariff is located: _____ _____. OTI/freight forwarder: bond #: _____ ___, Surety: _____. Amount: $_____ ____, Effective date: _____ _____. OTI/NVOCC: bond #: _____ _____, Surety: _____. Amount: $_____ ____, Effective date: _____ _____. IF ENGAGED IN INTERNATIONAL SHIPPING: OCEAN CARRIERS USED: _____. COUNTRIES SHIPPED TO / FROM _____. AUDITED FINANCIAL STATEMENT ATTACHED YES NO. SIGN BACK AND RETURN BY: EMAIL - MAIL - 9487 Regency Square Boulevard Jacksonville, FL 32225.
3 FAX - 904-722-5258. CREDIT APPLICATION AND AGREEMENT - Terms and Conditions As consideration for the grant to Applicant of CREDIT Applicant understands and agrees that, to the extent Notice to Applicant. The cancellation of CREDIT shall with respect freight or other charges in connection applicable at lawditions and not in conflict with a governing not impair Crowley 's right to collect payment for all with services provided by Crowley Holdings, Inc. private contract or tariff and/or service contract services, freight and other charges for which CREDIT and/or its affiliates (each of which, as applicable is terms and conditions between Crowley and has previously been extended in accordance with referred to herein as Crowley ), Applicant agrees as Applicant covering the same subject matter, this the terms of this AGREEMENT .
4 Follows: AGREEMENT shall be governed by and construed in accordance with the laws of the United States of In this AGREEMENT , Crowley means Crowley , its Applicant shall be unconditionally responsible for all America and Applicant agrees that any suit arising parent and other affiliated companies and each of charges for services, freight or other charges for out of or relating to this AGREEMENT shall be brought their officers, directors, employees, agents, which CREDIT has been extended pursuant to this in a United States District Court located in the contractors or assigns; "Applicant" means the AGREEMENT . If the services of an Agent or Agents (as Southern District of New York, the Middle or natural person or legal entity signing this AGREEMENT herein defined) are utilized in connection with the Southern Districts in the State of Florida, or the and any of their partners or affiliates that Crowley payment of freight or other charges to Crowley , Eastern District of the State of Washington and, that has permitted in writing to receive CREDIT hereunder.
5 Applicant agrees that such Agent(s) act as Shipper's once brought the court so chosen shall have Agent means an Ocean Transportation or consignee's agent for such purposes and not as exclusive jurisdiction to hear such disputes Intermediary (as that term is defined in the Section agent of Crowley . Applicant further specifically hereunder, including but not limited to any disputes 1702 of the Shipping Act of 1984, as amended by agrees that, in extending CREDIT hereunder, Crowley relating to freight or other sums payable to Crowley the Ocean Shipping Reform Act of 1998), third party is relying upon Applicant's CREDIT standing and upon for carriage to or from the United States of America logistics provider or any other person or entity Crowley 's lien on the Goods (as herein defined), and or its Territories.
6 Applicant agrees that failure to pay acting for or on behalf of Applicant as a broker or not upon the CREDIT of such Agent or Agents. The any charges required to be paid to Crowley in the forwarding agent relating to any and all transactions term Prepaid on Crowley 's bill of lading issued to State of Florida shall be deemed an act of breach of in connection with this AGREEMENT or in connection Applicant or its Agent does not mean that freight this AGREEMENT committed in the State of Florida with any services provided by Crowley pursuant to and related charges have actually been paid and if, that subjects Applicant to jurisdiction of Florida's any other AGREEMENT entered into by Crowley in for any reason, the Shipper fails to pay such courts and that in such event if Crowley files suit reliance on this AGREEMENT .
7 Shipper means, promptly, Crowley shall also seek payment from against Applicant for such payment in one of the collectively, the natural person or entity named as consignee or the beneficial owner of the Goods. aforementioned courts located in Florida, Applicant such in any applicable bill of lading, the consignor, The term Collect on Crowley 's bill of lading issued has expressly waived its right to contest jurisdiction the consignee, the beneficial owner of the Goods, to Applicant or its Agent indicates only that Crowley of such court. In the event Applicant is delinquent in the holder of the bill of lading and the natural agrees in the first instance to seek payment of payment of freight and other charges, Applicant person or legal entity for whose account the Goods freight and related charges from consignee prior to shall bear all costs of collections plus liquidated are shipped or other services are provided by release of the Goods at the port of destination and damages of twenty-five (25) percent of any freight Crowley , which person or entity may be Applicant.
8 If, for any reason, consignee fails to pay such bill as a reasonable estimate of Crowley 's damages CREDIT means the value program established for promptly, Crowley shall also seek payment from which are at this time difficult to ascertain and, not the Applicant pursuant to the terms of this Shipper or the beneficial owner of the Goods. as a penalty, whether suit is brought for such APPLICATION and AGREEMENT ; "Account" means an Applicant shall be absolutely and unconditionally delinquency or a collection agent is employed. account opened pursuant to this AGREEMENT that responsible for payment to Crowley of all charges for Applicant agrees that the shipper, consignee, holder Crowley may bill directly or through an Agent to the Crowley services, freight and other charges due of any applicable bills of lading, and owner of any Applicant.
9 And Goods means the cargo/commodity Crowley at its own risk, and in the event an Agent applicable goods and their principals, shall be jointly accepted from Shipper and includes containers, converts such funds to its own use or for any other and severally liable to Crowley for the payment of all vans, trailers, rail cars, and/or rolling equipment reason fails to pay them to Crowley , Applicant shall freight, demurrage, general average and other whether supplied by Crowley or not. remain absolutely and unconditionally liable to charges due Crowley . Crowley shall also have a lien Crowley for the payment of such amounts due and The information on the attached CREDIT APPLICATION on any goods in Crowley 's possession or control for and AGREEMENT is provided for the purpose of owing Crowley for its services, including but not any charges payable to Crowley under this limited to freight and other charges.
10 In no event inducing Crowley to extend CREDIT to Applicant and AGREEMENT and for all previously unsatisfied debts Applicant warrants such to be true and correct as of shall any demand by Crowley upon such Agent or due to Crowley by the Shipper, consignee, or owner Agents for payment of such amounts due and owing the date hereof. In the event Applicant is merely the of the Goods. Where permitted by law, Crowley 's Shipper or an Agent and otherwise not the beneficial Crowley constitute a waiver or an estoppel of lien shall cover any charges payable to Crowley by Crowley 's right to enforce Applicant's undertaking owner of the Goods for which Crowley will be Applicant under any other AGREEMENT or bill of lading providing services, Applicant hereby expressly herein.