Prime Meats

Ac co un t Pro file and Credi t Appli cat i o n

CENTER-OF-PLATE CHEF SOLUTIONS

2150 Boggs Road Duluth, GA Building 500 30096 Phone: (800) 68-MEATS

www.primemeats.com

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Date of Agreement (Month/Day/Year)

Fax or email application to: 770-414-8966 accountapplication@primemeats.com

Market:

Company Information Legal Business Name: Trade Name D/B/A/: Billing Address: State:

City:

Phone:

Zip:

FEDERAL ID #

DUNS# ( ) CORPORATION (

) PARTNERSHIP ( ) PROPRIETORSHIP ( ) LLC ( ) OTHER

Payment Agreement Anticipated weekly purchase volume: $

NO

al

Yes

Charge Sales Tax:

Reseller/Resale Tax Exempt Certificate Number: Number of years in business:

Number of employees:

Other:

Days To Pay:

ti

C.O.D

Payment Terms Requested:

MONDAY AM

TUESDAY AM

PM

PM

en

DELIVERY PREFERENCES WEDNESDAY AM

THURSDAY AM

PM

FRIDAY AM

PM

PM

SATURDAY AM PM

id

Additional Delivery Locations

Address:

State:

City: City: Address: City:

co

Address: City:

Phone:

State:

Zip:

Phone:

State:

Zip:

Phone:

State:

Zip:

Phone:

nf

Address:

Zip:

SPECIAL INSTRUCTIONS: 111 Name:

OWNER (S) Partner(S) OFFICER (S) NAMES AND TITLES City:

Residence Address: Date of Birth: 2.

/

Title:

/

Name:

Date of Birth:

Title: /

City: /

Zip:

S.S No.:

Drivers License No.:

Residence Address:

State:

Drivers License No.:

2150 Boggs Road Duluth, GA Building 500 30096 Phone: (800) 68-MEATS

State:

Zip:

S.S No.:

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BANK REFERENCE (2) Address:

111 Bank Name: Phone:

Contact:

Account No.: 2.

Bank Name:

Address:

Phone:

Contact:

Account No.:

TRADE REFERENCES (3) MINIMUM OF 3 REQUITED

Preferred Contact:

111 Vendor Name: Street Address: State:

City: 2.

Phone:

Zip:

Preferred Contact:

Vendor Name: State:

City:

Phone:

Zip:

Vendor Name:

Preferred Contact:

Street Address: Zip:

id

Additional Comments:

Phone:

en

State:

City:

ti

3.

al

Street Address:

co

nf

Service charge of 2% per Month will be assessed on all past due accounts. This application represents that the above information is correct to the best of the applicant’s knowledge and authorizes Prime Meats to verify information by the use of credit reporting agencies and/or bank and trade references listed above. Applicants signature attests financial responsibility and ability (and willingness) to pay all invoices in accordance with Prime Meats Terms and Conditions. Prime Meats standard terms are net 7 days from invoice date unless otherwise stated. Terms may be adjusted at anytime based on payment size, frequency and checks returned for non sufficient funds.

Signature:

Name:

Date:

Title:

In consideration for Norsan Meats INC., I agree to pay all invoices according to your terms and to pay reasonable attorney fees if it becomes necessary to enforce collection. The undersigned Principal owner(s) hereby personally, individually guarantee prompt payment of all invoices due or to become due owing to Norsan Meats INC.

2150 Boggs Road Duluth, GA Building 500 30096 Phone: (800) 68-MEATS

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CENTER-OF-PLATE CHEF SOLUTIONS

For Internal Use Only ORDER#: Type LV : Approved: Credit Limit $ Bank Response:

Sales Rep: TMCD Authorized by: Approved by: Account #: Trade 1 :

Broker:

Trade 2:

Terms: Credit Rep: Trade 3:

D&B:

Comments

2150 Boggs Road Duluth, GA Building 500 30096 Phone: (800) 68-MEATS

www.primemeats.com

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