::: Credit Application :::

			Asbestos Abatement
			Demolition
			Roll-off Containers
			Landfill Services
			Request A Quote
			Salvage/Brick Sales

Apply

Name of Company:

Contact Name:

Address:

City:	State:	ZIP Code:
Phone:	Fax:	Email:
Billing Address: (if different)
City:	State:	ZIP Code:

BANK ACCOUNT INFORMATION

Bank Name

Phone Number

Account Number

Account Type

CREDIT REFERENCES

Credit or Name

Phone Number

Contact Person

CREDIT TERMS

By signing this application, I acknowledge that I have read, understand, and will abide by the following terms:

You will receive a monthly statement detailing each month’s charges. The statement will reflect all work completed by the date of the statement; orders called in before the statement date but not completed by that date will appear on the following month’s statement. All statement charges should be paid in full by the 10th of the following month.

A late fee of 1.5% per month (18% annually) will apply to any balance not paid within 60 days of the original statement date.

Failure to pay your bill in a timely manner may result in account suspension; repeated failure to pay in a timely manner will result in the closure of your account.

If you have any questions about your bill, please contact the office immediately.

I authorize Reaves Wrecking, et al., to verify the information provided on this form.

Authorized Company Representative (Print Name)	Title

Authorized Company Representative (Signature)	Date