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1.) Download a credit application and fax to us at 281-469-9728 or mail to:

     STVA Scaffold
     Attention: Credit Department
     P.O. Box 690725
     Houston, TX 77269-0725


OR


2.) Apply online through our secure site below which uses 128bit encryption for security.


Credit Application and Agreement
All field marked with * are required
A.) Applicant
* Legal Business Name
(List all trad name, DBA, divisions and/or subsidiaries)
Date:
   
* Street Address
* City
* State
* Zip
   
* Mailing Address
* City
* State
* Zip
   
* Phone Number
Fax
* Email
   
* Shipping Address
* City
* State
* Zip
   
   
* Estimated Annual Sales
* Accounts Payable Contact
* Credit Requested
* Type of business
* Years in business
* Estimated Amount of 1st Order



B.) Company Information
* Type of entity
 
* Partner
* SS#
Partner
SS#
Federal Tax ID#
(If applicable)
   
* Sales Tax Exemption Certificate
(If "YES", include a fax copy but mail us an original signed certificate.)
Yes No    
* State of Incorporation
*Year



C.) Banking Information
* Bank Name
* Branch
* Address
* City
* State
* Zip
* Officer Contact
* Phone
* Account Number
* Type of Acct.
Account Number
Type of Acct.
   
  I hereby authorize the bank named above to release information requested for the purpose of obtaining and/or reviewing credit.
   
  By placing your name in the box below, you have read and agree to the above terms.
* Full Name
* Title Date



D.) Trade References (List 3 references)
* Trade Reference #1 Name
* Address
* City
* State
* Zip
* Contact Person
* Phone #
*Fax # (must include)
   
   
* Trade Reference #2 Name
* Address
* City
* State
* Zip
* Contact Person
* Phone #
*Fax # (must include)
   
   
* Trade Reference #3 Name
* Address
* City
* State
* Zip
* Contact Person
* Phone #
*Fax # (must include)
   
   
E. Location of Collateral Until Payment
 
   
AN OFFICER OR CONTROLLER OF THE COMPANY MUST SIGN AGREEMENT:
* Company Name
* Completed By
* Title
Date
   
F. Consent to Obtain Credit Repport
The undersigned individual, who is either a principal or a controller of the credit applicant, consents to and authorizes the use of a credit report on the business applying for credit, from time to time as may be needed, in the credit evaluation process.
   
* Full Name
* Title
Date
 



G.) Company Financial Information
* Fiscal Year Ended
* Current Assets:
* Current Liabilites:
* Other Assets
* Net Worth:
* Sales:
* Long Term Liabilities:
* Net Profit (Loss):
I hereby affirm that the aforementioned financial information is true and correct.
* Full Name
* Title
Date
 
 

H. Personal Guarantee
 

For valuable consideration, the receipt of which is acknowledged, including but not limited to the extension of credit by STVA Scaffold to the undersigned, individually, jointly and severally, absolutely and unconditionally guarantee(s) to STVA Scaffold, which shall include its affiliates and subsidiaries, the full, complete, faithful and prompt payment by , of all obligations which Guarantor presently or hereafter may have to STVA Scaffold, and payment when due of all sums presently or hereafter owing by Guarantor to STVA Scaffold. Guarantor agrees to indemnify STVA Scaffold against any losses it may sustain and expenses STVA Scaffold may incur as a result of any failure of Guarantor to perform including reasonable attorney's fees and all costs and other expenses incurred in collecting or compromising any indebtedness of debtor guaranteed hereunder or in enforcing this guaranty against guarantor. This shall be a continuing Guaranty Diligence, Demand, Protest or notice of any kind is waived. It shall remain in full force until guarantor delivers to STVA Scaffold written notice revoking it as to future indebtedness incurred after such delivery. Such delivery shall not affect any of guarantors' obligations hereunder with respect to indebtedness incurred prior to STVA Scaffold receiving notice. The guaranty is a continuing guaranty and shall remain in full force and effect until the later of (1) the performance or payment in full of the guaranteed obligations, and (2) the termination of all continuing obligations and commitments of obligor.

Guarantor agrees to be bound by all terms described herein or any amendments hereto made in the future and waives actual notice of said amendments. Amendments to the terms of this agreement, assignment of this agreement or extensions of the time of performance shall not releaseany undersigned Guarantor unless STVA Scaffold specifically and agrees in writing to the release of Guarantor.

In the event of termination for default, or in the event of failure, insolvency, default, bankruptcy, appointment of receiver or other liquidation of the principal obligor, the guaranty herein shall become absolute. The Guarantor waives notice of default on the part of obligor. Guarantor shall be responsible for all costs or expenses incurred by STVA Scaffold in enforcing this guaranty.

The Guarantor stipulates and agrees that this agreement is performable in Houston, Harris County, Texas. The undersigned personal guarantor, recognizing that his or her individual credit history may be a necessary factor in the evaluation of this personal guarantee, hereby CONSENTS TO AND AUTHORIZES THE USE OF A CONSUMER CREDIT REPORT on the undersigned, by the above named business credit grantor, from time to time as may be needed, in the credit evaluation process.

   
In Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington State, and Wisconsin, Guarantor and Spouse shall each sign below:
* Guarantor Full Name
* Title
Date
* Complete Home Address
* Social Security Number
 
 
* Guarantor Full Name
* Title
Date
* Complete Home Address
* Social Security Number
 
 

I. Required Additional Information
The following information is needed by the STVA Scaffold Credit Department
   
* 1.) Is there a parent company? Yes No
   
2.) If yes, please provide all the following:  
   a. Complete Legal Name
   b. Physical Address
   c. Mailing Address
   d. Telephone Number
Fax
   e. President's Name
   
* 3.) Where will checks be issued from?  
   a. Company Name
   b. Physical Address
   c. Telephone Number
Fax
   d. Contact Person
   
* Do you want the credit report run on the division or parent company? Division Parent Company
   
 

Thank you for your cooperation in completing this application, we are looking forward to developing and maintaining a long lasting business relationship.

STVA Scaffold

   
 

 

Mailing Address
P.O. Box 690725
Houston, TX 77269-0725

Address
12423 Huffmeister Rd.
Cypress, TX 77429

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