Purchaser - Phone *

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Business Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have the business or major owners ever filed for bankruptcy? *

Yes

No

Please Read *

It is agreed and understood that terms of sale shall be Net __ days from the date of invoice. Upon the expiration of ___ days a service charge equal to the rate of one and one-half percent (1  %) per month or any part thereof. It is further agreed that if said account is turned over for collection, interest, reasonable attorney's fees, collection agency's fees, and/or costs of collection shall be added to the unpaid balance, whether or not legal action is instituted. Other terms and conditions shall be provided at the time of billing.

I Agree

Terms & Conditions *

The Purchaser named on the reverse side of this Credit Application and Agreement agrees that all purchases made by the Purchaser or by any person representing himself to be an employee, agent or representative of the Purchaser from Land & Sea Provisions and its affiliates (the Seller) shall be subject to the credit terms and conditions of the Seller as established and amended from time to time, including the terms and conditions set forth herein. The Purchaser represents and warrants that the information furnished herein is true, correct and complete. The Purchaser hereby authorizes the Seller to investigate and obtain information from all banks and other credit references and sources (whether or not listed in this Credit Application and Agreement) regarding the Purchaser's creditworthiness. All credit extensions shall be make at the sole discretion of the seller and may be denied, altered or terminated by the Seller at any time without cause. In the event of any change in the ownership of the Purchaser or the Purchaser's business, the Purchaser shall be jointly and severally liable with its successors for all sales to such successors that originate and are charged to the Purchaser's account before the Seller receives notice by registered or certified mail of such change in ownership. The Seller reserves the right to require any such successors to submit a new credit application prior to any extension of credit to such successors. The Purchaser agrees to pay all amounts due to the Seller in full in accordance with the terms stated on each invoice. Any amount not paid when due to the Seller shall bear interest at the rate of eighteen percent {18%} per annum or the maximum lawful rate until paid. A service charge shall be payable by the Purchaser for any check returned by the Purchaser's bank. The Purchaser shall pay all attorney's fees, collection and court costs and other expenses incurred by the Seller to collect any obligations owing by the Purchaser, whether or not incurred in connection with litigation. The Purchaser agrees that the venue of action to enforce this Credit Application Agreement shall be at the Seller's option. All perishable agricultural commodities are sold subject to the statutory trust authorized by section 5(C) of the Perishable Agricultural Commodities Act, 1930 (7 U.S.C 499e(c)). The Seller retains a trust claim over these commodities, all inventories of food or other products derived from these commodities, and any receivable or proceeds from the sale of these commodities until full payment is received.

I Agree

Signature *

First Name

Last Name