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Credit Renewal

Questions?

Angela Denison,

Accounting Manager

Phone

Mail

Credit Application

For a printable version, please click the below link, complete the application, and submit to any SealMaster Indiana or Kentucky location, or e-mail to angela@sealmasterindy.com.

This site is best utilized on a desktop or laptop computer. If accessing thru mobile, you do not need to use Microsoft Edge; you may use your normal mobile browser.

Business/Legal Name

Street Address

City

State

Zip code

Main Phone Number

Business Type: *

Corporation

LLC

Sole Proprietorship

Partnership

Tax ID Number

Tax Exempt? *

No

Yes (please upload your applicable state tax exempt form)

Upload File

Upload supported file (Max 15MB)

Principal Officers / Partners

Principal Officer #1: First and Last Name

Street Address

City

State

Zip Code

Phone Number

Title

Principal Officer #2: First and Last Name

Street Address

City

State

Zip Code

Phone Number

Title

Accounts Payable
Please indicate where to send your invoices, statements, etc.

Method of invoice and statement delivery: *

E-mail

USPS Standard Mail

Accounts Payable Contact First and Last Name

Phone Number

E-mail Address

Do you require a purchase order number for transactions? *

No

Yes

Authorized Employees

Authorized Employee #1: First and Last Name

Authorized Employee #2: First and Last Name

Authorized Employee #3: First and Last Name

Please check each box to confirm understanding and agreement:

Credit terms are net 30 days unless otherwise indicated.

Any unpaid balance after such date will incur a late fee of 1.5% monthly on the unpaid balance until paid in full, plus all collection costs and attorney fees incurred to collect unpaid balances.

Bernath LLC dba SealMaster reserves the right to (1) maintain, raise, or lower the credit limit on applicant's account at its discretion, and (2) terminate this applicant’s account at any time, in which case immediate payment of balance in full will be required.

We will normally accept returned material under the following conditions: (1) A copy of the invoice is furnished. (2) The material is returned within 60 days from the date of the invoice. (3) The material is in new and resalable condition. (4) The material is a normally stocked item (not a special or custom order). (5) A 15% restocking fee. (6) If applicable, freight charges will remain imposed.

The buyer hereby grants Bernath LLC dba SealMaster, a purchase money security interest in the equipment/materials described in the invoices. To secure the debtor’s payment for equipment/materials, it shall remain the seller’s until payment in full is made by the buyer.

If the buyer defaults in such payment, the seller may declare all the sums payable by the buyer hereunder immediately due payable and the seller may reclaim the equipment/materials and or exercise all the rights and remedies of a secured party under the Uniform Commercial Code.

In consideration of the extension of credit, the undersigned agree(s) to be personally responsible for such indebtedness, as may be incurred from time to time, together with collection costs and reasonable attorney fees.

The undersigned hereby certifies the information provided to Bernath LLC dba SealMaster is true and correct to the best of his/her knowledge and authorizes the release of information on this account for the purpose of extending credit.

The undersigned certifies that he/she is an authorized representative of applicant with both the power and authority to sign this agreement.

The undersigned agrees that affixing his/her electronic signature to this Agreement is the same as affixing his/her manual handwritten signature for the purposes of validity, enforceability, and admissibility.

Electronic Signature

First and Last Name

Title

Today's Date

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Disclaimer: Pictures may not represent current condition of the equipment, as many assets are part of rental fleet. Assets may be stationed at any one of our storefront locations.

The equipment shown is not a comprehensive list; many new and used assets are not yet listed.

Call your local sales representative or storefront for details!

Notice regarding United Healthcare Transparency in Coverage: transparency-in-coverage.uhc.com

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Credit Renewal

Principal Officers / Partners

Accounts Payable Please indicate where to send your invoices, statements, etc.

Authorized Employees

Accounts Payable
Please indicate where to send your invoices, statements, etc.