*Marks required fields.
*Name: Phone #:
City: State: SelectALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip:
Street Address: *Email:
Contact Person: Phone #:
Job Type: New HomeAddition to HomeOther
I hereby certify that the above statements are true and complete and are made for the purpose of obtaining credit. The undersigned form and in consideration of the extension of credit for the purchase of merchandise and building supplies from SPAKE CONCRETE PRODUCTS, hereby agrees to make all payments within the terms of credit extended. All purchases made by the 25th day of any month will be considered due and payable on or before the 10th day of the month following purchases. Any account unpaid by the 10th of the month following purchase will be considered delinquent. It is understood and agreed that the purchaser will pay a monthly service charge of 1-1/2% per month on any unpaid balance as of the 25th of the month following the purchase.
I hereby guarantee payment of all purchases and any service charge that accrues.
Agreement is acknowledged this day of , 20 at Shelby, Cleveland County N.C.
*Applicant Full Name: