| Company Name:* |
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| Company Address:* |
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| Room/Floor/Suite: |
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| City:* |
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| State:* |
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| Zip Code: |
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| Phone Number:* |
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| Fax Number: |
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| Email Address:* |
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If your billing address or email is different from your general correspondence: |
| Accounts Payable Contact: |
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| Accounts Payable Address: |
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| Room/Floor/Suite: |
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| City: |
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| State: |
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| Zip Code: |
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| Phone Number: |
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| Fax Number: |
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| Email Address: |
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| Type of Business:* |
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| Years Established:* |
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| How would you like to receive your invoices? * email/fax/mail: |
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| How would you like to receive proof of delivery?* email/fax/mail: |
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| How much are your average monthly courier bills?: * |
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| How did you hear about us?*: |
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| Business Associates/References: |
| 1. Company:* |
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| Contact Name:* |
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| Address:* |
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| City:* |
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| State:* |
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| Phone Number:* |
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| 2. Company:* |
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| Contact Name:* |
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| Address:* |
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| City:* |
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| State:* |
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| Phone Number:* |
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| Bank References: |
| Bank Name:* |
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| Account Number:* |
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| Branch Address:* |
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| Branch City/State/Zip code:* |
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| Phone Number:* |
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| Contact Person:* |
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| Credit Card Authorization |
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Please provide a credit card number to establish credit. Invoices that remain open in excess of 30 days may be charged.
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| Card holder's Name:* |
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| Address:* |
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| City:* |
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| State:* |
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| Card Type: * |
VisaMCAmexDiscover |
| Card Number:* |
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| Expiration Date:* |
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| Security Code: * |
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Note:
If you wish to receive emails from BOCSIT regarding your statements and proof of delivery, please remember to add our email address to your Safe Sender list in your email program so that important emails such as these don’t risk being blocked as spam. |
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Terms and Conditions
In opening this account, please be advised that BOCSIT, does not take responsibility for cash, jewelry or securities. BOCSIT limits its liability to maximum of 100.00 (one hundred dollars ) per delivery unless otherwise negotiated in writing. In consideration for credit being extended by BOCSIT, I acknowledge and agree to the following: (1) Payment for all work performed by BOCSIT is personally, jointly, severally, and unconditionally guaranteed within 15 days of billing; (2) any charges outstanding after 30 days can be charged on the credit card indicated above; (3) any charges outstanding after 60 days from date of billing are subject to collection, and all collection or arbitration expenses, attorney fees, and court costs will be borne by the purchaser; (4) all claims, requests for adjustments, or notification of errors must be made within thirty days; or charges are considered accepted; (5) BOCSIT assumes no responsibility for the condition of the item being shipped; (6) this agreement shall apply to all current and future charges unless revocation is registered mail;(7) releases BOCSIT its employees and or agents from liability and responsibility for the condition of the items throughout the receipt and delivery process (8) represents to BOCSIT that the contents of the shipment is not hazardous or illegal in nature.(9) all work is subject to the Terms and Conditions above. My name below is confirmation that I have read and understand this agreement.
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By checking this box i affirm that i have read and undertand the terms and conditions specified in this form.Below is my printed name. |
| Authorized Virtual Signature:* |
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| Date:* |
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