Transcription of Pipe Pipe -Structural • Steel• -Valves -Fittings …
1 6385 Hwy87 E San Antonio, TX 78222 (210) 223-7473(210) 223-7477 Fax10243 Hwy 290 W Hye, TX 78635 (210) 868-0200(830) 868-4549 FaxPipe - Structural - Valves - Fittings - Fencing - Supplies Pipe Steel Supplies 2248 Hwy90W Hondo, TX 78861 (830) 741-2000(830) 426-8999 Fax409 Industrial Ave Robstown, TX 78330 (361) 767-7473(361) 387-7477 Fax103 Lafayette Drive Kerrville, TX 78028 (830) 367-7 473(830) 367-3092 Fax3145 N SH 16 Hwy Jourdanton, TX 78026 (830) 769-1234(830) 769-1230 Fax408 Boomtown Laredo, TX 78043(956) 727-7473(956) 727-7474 FaxPlease complete entirely and return application to or fax to (866} 944-7472 CREDIT APPLICATION PREPARED BY :, _____ Amt.)
2 Of Credit Requesting: _____ PMI SALES REP ,__ ____ _ LEGAL BUSINESS/APPLICANT NAME: _____ SSN/FEIN: _____ _ DB,,_ _____ _ TDL#_ _____ PHONE #: _____ E-MAIL_ _____ _ MAIN ADDRESS: _____ CITY, STATE & ZIP: _____ _ ** SECTION BELOW IS FOR BUSINESS ACCOUNTS ONLY** !LEGAL ENTITY: CORP [ ] PARTNERSHIP [ ] PROPRIETORSHIP [ ] LLC [ ] LLP [ ] LLLP [ ] Govt [ 11 STATE OF INCORPORATION: YEAR BUSINESS STARTED: NAICS/SIC CODE: -----------------PRODUCTS OR SERVICES OFFERED: _____ PO REQUIRED? YES [ l NO [ TAX EXEMPTED: SALES TAX EXEMPT CERTIFICATE [ ], RESALE CERTIFICATE [ ], OR DIRECT PAY CERTIFICATE [ ] **PLEASE PROVIDE CERTIFICATE, EXEMPTION NUMBER ALONE WILL NOT BE ACCEPTED** TX SHIPPING ADDRESS: _____ CITY, STATE, & ZIP: _____ _ If Different From Main BILLING ADDRESS: _____ CITY, STATE, & ZIP: _____ _ 1) Name Title 2) Name Title 3) Name Title 4) Name Title OFFICERS (OWNERS/PARTNERS/MEMBERS) Required Phone Phone Phone Phone DL# Filed or Adjudged Bankruptcy?]]]
3 DL# Filed or Adjudged Bankruptcy? DL# Filed or Adjudged Bankruptcy? DL# Filed or Adjudged Bankruptcy? PURCHASING CONTACT: _____ _ Print Name Phone E-mail ACCOUNTS PAYABLE: _____ _ Print Name Phone E-mailPage 1 of 3
