Business Account Application

Contact Information
Your Name
First Last
Your Phone
Your Email
Business Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Business Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Business/Trade References
Two References
Click the plus icon to add a second line.
Company Name Contact Name Phone

Authorized Signers
Please list any names of those you give permission to use the account:
Signer 1
Name
Signer 2
Name
Signer 3
Name
Signer 4
Name
Signer 5
Name
Invoicing & Statements
Choose your preferred method of delivery:
Choose email, mail or both options.
- Email
- Mail

Agreement
By submitting this application, I authorize Edgartown Hardware, Inc. to make inquiries into the business/trade references that I have supplied. Discounts applied to an account are based on a total amount purchased annually and are reserved for licensed contractors only which are not transferable. Billing period ends the 25th of each month and discounts are available only until the 10th of the following month. If a line of credit is approved, I agree to pay for all services and material that I or my authorized signers have purchased. Any dispute claims arising from invoices must be made before the closing of the next billing period. Any payment received past 30 days will be subject to a 2% service charge. If an account balance default occurs beyond 90 days, I agree to pay for all collection costs and expenses, including any court and attorney's fees incurred by Edgartown Hardware, Inc. At any point Edgartown Hardware, Inc. may reduce your credit line or close your account without notice and/or refuse additional purchases if any of this agreement is breached. I may close my account with Edgartown Hardware, Inc. without notice if there is no account balance. Submission of this application does not guarantee approval. Please contact the account manager, Kat Montes at 508-627-4338 option 3 for additional details. Please allow at least 24 hours for a response.
Your Name
Name
Submission Date
Date Format: MM slash DD slash YYYY

Grow With Us

Company Name	Contact Name	Phone