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Credit Application
Company Name: Compressor & Blowers Service_______ Phone: +504 2556-5684__________________
Business Type:
___ Corporation ___ LLC ___ Sole Proprietorship ___ Partnership ___ S-Corporation
_X_ Other (please explain)_Sole Trader____________________________________________
Is Your Company Tax Exempt: Y / N If Yes, Please Provide a Copy of Each Applicable States Certificate
Bank Reference
Name: _ eCompressedair ___ Address: 251 union street, Westfiel,MA 01085 Phone:413.562.2324_
Email /kim.cottengim@ecompressedair.com Fax: ____________________
Name: Industrial Compressor Supply Address: 316 fee fee Rd.,Maryland heights,MO63043 Phone: 877.426.3131_
Email /Dawn@eaircompressorparts.com Fax: ____________________
Name: _ Ring Power ___ Address: 3400 N.W. 77 Th court,FL 33122 Phone:413.562.2324_
Email /denis.caja@ringpower.com Fax: ____________________
Note: Past Due Account Balances Are Subject To An 18% Per Annum Service Charge
Signature:____________________________________________ Date:_13-03-2017_____________________
(Authorized Officer of Company)
Title:________________________________________________
Return the Completed Application to Fax (217) 228-8267, Attention: Vicki Kuhlmeier.