Fill - Collections Creditapplication05 2017h

CREDIT APPLICATION

Submit the completed form to credit@unitedelectric.com,

fax to (302) 324-3330, or mail to:

United Electric Supply

P.O. Box 10287

Wilmington, DE 19850

Attention: Credit Department

Federal ID #51-0102767

Account

Approval

Limit

Sales Number

Customer Number

Date

Company Name

Billing Address City State Zip

Shipping Address City State Zip

Nature of Business Phone ( ) Number of Years in Business

Fax Number ( ) Email

Please check one ¨ Corporation ¨ Individual ¨ Partnership

Full Name of Corporate Officers and Titles

Federal Tax Number

Name(s) / Social Security Number(s)

Are Purchase Orders Required?

¨ Yes ¨ No Sales Tax Status Taxable Exempt (if exempt, attached exempt certificate)

For Contractors License Number

State License Principal Bonding Company

Address City State Zip

Sr. Purchasing Agent Phone ( )

Trade References

Company Name Phone Fax Email

( ) ( )

Principal Bank Address

Account Number Bank Officer in Charge of Account Phone ( )

Payment Terms: Service charge of up to 2% will be assessed on overdue balances. Account exceeding the 30 day period will be subject to restricted credit.

Payment records dictate the acceptable limits of credit. Unauthorized deductions or discounts will be considered overdue and billed back on account. In the

event your account is referred to collections or United Electric Supply otherwise undertakes efforts to collect its account, you expressly agree to pay all costs of

collection, including attorneys’ fees, court costs, and other expenses reasonably incurred in connection with such collection efforts.

Annual Sales Volume $ Credit Limit Requested $ Estimated Monthly Purchases $

Special Billing Requirements

The Company hereby acknowledges its receipt of United Electric Supply Terms and Conditions and hereby agrees that such Terms and Conditions are appli-

cable to all purchases made by the Company from United Electric Supply (whether made by purchase order or other purchase arrangement, including any pur-

chase arrangement made in writing, by electronic transmission, telephonically, orally, or otherwise), and that such Terms and Conditions are hereby incorporat-

ed by reference into this Credit Application and into any purchase order or other such purchase arrangement between the Company and United Electric Supply.

IN WITNESS WHEREOF, intending to be legally bound, the Company has caused this Credit Application to be legally executed as of the date set forth below.

Company Name Date

Signature Title

Please Complete Reverse Side

F109 Rev, 05/2017

PERSONAL GUARANTEE

In consideration of United Electric Supply Co., Inc., hereinafter referred to as United, extending credit to

hereinafter referred to as debtor, for goods that have been or may be sold to debtor from time to time by United upon consideration of the present forbearance by

United on any existing indebtedness (which forbearance United can terminate at any time by notice to debtor) and of the continued extension of credit to debtor,

we jointly and severally agree as follows:

Upon demand, we will immediately pay to United or assigns, any sum due by debtor to United and unpaid after the due date thereof.

It is understood that United may, without consulting or notifying us:

Extend the due date of any indebtedness, or any part thereof owed to it by debtor.

Accept any promissory note or other evidence of indebtedness from debtor, and renew or extend any such note or other evidence of indebtedness.

Accept collateral in any form for any such indebtedness.

Assign this guarantee in whole or in part in conjunction with the sale, assignment or transfer, in whole or in part, of the indebtedness herein guaranteed,

in which event the assignee, transferee or holder of the indebtedness shall have the right to enforce this guarantee, by suit or otherwise for his/its

benefit as fully as if this guarantee specifically names such assignee, transferee or holder, but United shall have an unimpaired right to enforce this

guarantee for its benefit as to any part of the indebtedness herein guaranteed which it does not sell, assign or transfer.

Any such action on the part of United shall not relieve us of our obligation under this guarantee,

It is further understood that each of the Guarantors shall become liable to United or its successors or assigns under this Guarantee upon receipt of the Guarantee

by United and that United shall not be obligated to notify the Guarantors that it has accepted this Guarantee. Each of the Guarantors hereby waives presentment,

protest and notice of nonpayment of any note or other evidence of indebtedness accepted by United from debtor and any and all other surety defenses.

This is a guarantee of payment and performance and not of collection, and the liability of each of the Guarantors under this Guarantee shall be primary, direct and

immediate, and not conditional or contingent upon pursuit by United of any remedies it may have against debtor or against any other person or entity or against

any property of any person or entity.

If any of the present or future obligations of debtor owed to United is guaranteed by persons, partnerships, corporations, companies or other entities in addition to

the Guarantors, the death, release or discharge in whole or in part, or the bankruptcy, liquidation or dissolution of one or more of them, will not discharge or affect

the Guarantors’ liabilities under this Guarantee. Notwithstanding anything contained in this Guarantee to the contrary, this Guarantee shall continue to be effective

or be reinstated, as the case may be, if at any time payment of all, or any part thereof, of the present or future obligations of debtor owed to United is rescinded or

must otherwise be restored by United, whether due to any bankruptcy or insolvency or otherwise. The insolvency of debtor, and any bankruptcy or reorganization

proceeding with respect thereto, shall not affect in any way our unconditional and absolute liability hereunder.

If any of the Guarantors advances any sums to debtor, or its successors or assigns, or if debtor or its successors and assigns shall hereafter become indebted

to any of the Guarantors, such sums and indebtedness shall be subordinate in all respects to the amounts then or thereafter due and owing United from debtor.

Each of the Guarantors hereby irrevocably waives any and all rights to which any of the Guarantors may be entitled, by operation of law or otherwise, upon making

any payment hereunder, (a) to be subrogated to the rights of United against debtor with respect to such payment or otherwise to be reimbursed, indemnified or

exonerated by debtor in respect thereof, or {b) to receive any payment, in the nature of contribution or for any other reason, from any person or entity with respect

to such payment. No set-off, counterclaim or reduction, no diminution of an obligation, and no defense of any kind or nature that any of the Guarantors may have

against debtor or United shall affect, modify or impair the obligations hereunder of any of the Guarantors.

This Guarantee, and all claims or causes of action {whether in contract or tort) that may be based upon, arise out of or relate to this Guarantee shall be governed

by and construed in accordance with the laws of the State of Delaware applicable to contracts made and performed in such State, without regard to any conflict

of laws principles thereof.

Each of the Guarantors hereto hereby irrevocably and unconditionally agrees (a) to be subject to the jurisdiction of the courts of the State of Delaware and of the

federal courts sitting in the State of Delaware and {b} with respect to actions commenced in the courts of the State of Delaware or the federal courts sitting in the

Slate of Delaware, to the extent any of the Guarantors is not otherwise subject to service of process in the State of Delaware, that service of process may also

be made on such Guarantor by prepaid certified mail with a proof of mailing receipt validated by the United States Postal Service constituting evidence of valid

service, and that service made pursuant to {b) above shall, to the fullest extent permitted by applicable law, have the-same legal force and effect as if served upon

such party personally within the State of Delaware.

Husband Social Security Number Name (printed) Signature

Wife Social Security Number Name (printed) Signature

Husband Social Security Number Name (printed) Signature

Wife Social Security Number Name (printed) Signature

I hereby certify under my official seal that I am authorized as a Notary Public to administer oaths under the laws of the state of and that the foregoing was

subscribed and sworn to before me on the day and year first above stated

NOTARY PUBLIC

County of State of

SEAL HERE

TERMS AND CONDITIONS

1. Definitions - “United” means United Electric Supply Company, Inc. and any name under which it may trade”Purchaser” means the

person identified in the “sold to” or “quoted to” space on the reverse hereof.

2. Terms Governing Sale - Purchaser agrees to be bound by all of the terms and conditions set forth herein. Any terms and condi-

tions set forth in any purchase order or other document or any oral communication or written agreement which purports to be an

addition to this Agreement which is inconsistent herewith shall not be binding upon United unless made in writing and accepted by

the signature of an authorized officer or manager of United. Any term or condition of sale contained in any document prepared by or

received from Purchaser by United relating to the goods sold under this Agreement which is inconsistent with any term or condition

of this Agreement is hereby rejected by United, and shall have no effect.

3. Shipping Dates - Shipping dates furnished by United are approximate and shall not be deemed to be fixed or guaranteed.

4. Prices - All orders are subject to prices and terms of sale in effect on the date of shipment and such prices and terms are subject

to change without prior notice to Purchaser. Unless otherwise stated on the reverse hereof, all price quotations expire 30 days from

the date of quotation and prices do not include freight or, where applicable, any federal, state or local taxes of any nature, all of

which shall be paid by the Purchaser.

5. Cancellation of Orders - All cancellations of orders must be requested by Purchaser and approved by United in writing.

Purchaser agrees to pay for any and all costs incurred by United in connection with any cancellation request.

6. Returned Goods - Only returns requested by Purchaser and approved by United in writing will be permitted. Goods returned

for any reason other than a warranty claim will be subject to a restocking charge to compensate United for its reasonable

costs incurred with respect to such return. Under no circumstances will goods be accepted for return after 60 days from the

date of shipment.

7. Wire Cuts - United will not accept returns of wire which has been cut to specified lengths at Purchaser’s request.

8. Credit - Notwithstanding any prior extension of credit by United to Purchaser, if at any time, United determines, in its sole judgment,

that Purchaser’s financial condition does not justify United’s extension to it of credit in connection with any sale hereunder, United

may, at its option, require Purchaser to make full payment in cash prior to order entry, manufacture, shipment or delivery.

9. Payment Terms - Unless otherwise stated on the face hereof or of United’s invoice payment terms in connection with credit ap-

proved by United are net 30 days from the date of invoice, and United does not extend cash discount terms. A late payment charge

of 2.0% per month on past due amounts or, if less, the maximum permitted by law, will be added to all outstanding balances after

30 days from date of invoice.

10. Default - In the event Purchaser defaults in payment, United may, in its sole discretion, suspend shipment of goods on order at such

time. Purchaser shall be liable for all costs incurred by United in connection with such default including, but not limited to, attorney

and collection agency fees.

11. Risk of Loss - If goods are shipped directly from a manufacturer or vendor other than United to Purchaser’s shipping address

shown herein, the risk of loss of such goods shall not be on United. Otherwise, the risk of loss shall pass from United to Purchaser

upon (i) delivery to Purchaser’s shipping address, if shipped by United’s vehicle or (ii) delivery to a common carrier, if shipped by

common carrier. When goods are shipped by common carrier all claims for damages or losses in transit must be made by Purchas-

er directly to such common carrier. Purchaser shall be obligated to pay the full amount of United’s invoice in accordance with the

payment terms stated therein, or hereunder notwithstanding damage in transit by or disputes with common carriers.

12. Limitation of Liability - With respect to any claim against United arising in any way from the sale of goods hereunder other than

warranty claims, United’s liability shall not exceed the purchase price of such goods. UNITED SHALL NOT BE LIABLE FOR ANY

CONSEQUENTIAL, CONTINGENT OR INCIDENTAL DAMAGES WHATSOEVER INCLUDING, WITHOUT LIMITATION, BACK

CHARGES. United shall not be liable for damages of any kind resulting from any delay or failure to deliver or perform due to strikes,

lockouts or other labor difficulties, failure or delay of sources of supply, transportation difficulties, accidents, fires, acts of God, or

any other cause of like or unlike nature beyond United’s reasonable control.

13. Specification Changes - All manufacturers’ specifications, either contained in United’s catalogue, promotional literature or in any

other document are subject to change without notice to Purchaser and without liability to United.

14. Confirmations - Written confirmation by Purchaser of telephone or other oral orders must be clearly marked “confirming” to avoid

duplicate shipments. If this is not done and duplicate shipment occurs, Purchaser’s written confirmation shall be deemed to be a

separate order subject to terms and conditions of this Agreement.

15. Claims - Any claim against United other than warranty claims must be made in writing within ten (10) days after delivery and

must state the factual basis for such claim. Failure to make any such claim within ten (10) days of receipt of shipment shall constitute

acceptance of the goods and waiver of any and all claims with respect to such shipment. Purchaser agrees that warranty claims

shall be barred unless asserted by Purchaser by the commencement of an action within 12 months after delivery of the goods.

All provisions of this Agreement relating to warranties, remedies and claims shall survive any termination of this Agreement how-

ever arising.

16. Warranties - UNITED MAKES NO WARRANTY EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, ANY IMPLIED

WARRANTY AS TO MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE OR OTHERWISE, CONCERNING

GOODS SOLD HEREUNDER. Purchaser’s sole remedy with respect to defective goods purchased hereunder shall be limited to

pursuing warranty claims against the manufacturers of such goods. United hereby assigns to purchaser all rights and warranty

claims which it may have against the manufacturers of goods sold by it hereunder. United further agrees to use reasonable efforts

to cooperate with the Purchasers to obtain from such manufacturers, in accordance with such manufacturers’ customary practices,

the repair or replacement of any goods which are defective in workmanship or material. With respect to goods modified by United

at Purchasers’ request, United shall have no liability whatsoever in the event that such goods’ manufacturers’ warranties are voided

as a result of such modification.

17. Sales Representative - No United sales representative or other employee who is not an officer or manager of United shall have

authority to change or waive any of the terms and conditions of this Agreement.

18. Waiver of Jury Trial - In the event of litigation relating to this Agreement or the goods sold hereunder, Purchaser hereby agrees,

to the extent permitted by law, to waive any right that it may have to a jury trial on any and all issues that may be raised in such

litigation.

19. No Waiver - Nothing contained herein shall be construed to limit or waive any right or remedy of United under applicable federal,

state, or local laws.

20. Severability - The invalidity of any provision of this Agreement shall not invalidate or render unenforceable any other provision of

this Agreement.

21. Entire Agreement and Modification - This Agreement is intended by the parties hereto as a final expression of their agreement

with respect to the subject matter hereof, and is intended as a complete and exclusive statement of the terms and conditions of that

agreement (any prior agreement being superceded by this Agreement and such prior agreements are hereafter null and void). This

Agreement may not be modified, rescinded or terminated orally, and no modification, rescission, termination or attempted waiver of

any of the terms, provisions or conditions hereof (including this paragraph) shall be valid unless in writing, supported by consider-

ation, and signed by the party against whom the same is sought to be enforced.

22. Governing Law - All orders are subject to acceptance by United in Delaware and this Agreement shall in all respects be governed

by and construed under the laws of the State of Delaware.

TERMS AND CONDITIONS (CONTINUED)

ELECTRONIC INVOICING

At United Electric, our goal is to make it easy for you to do business with us.

Including managing invoices!

We encourage you to take advantage of our FREE electronic invoice delivery service; a better way for

you to get your Invoices and statements while helping the environment.

Electronic Invoicing Benefits

• Receive statements and invoices faster

• Earlier receipt will help you meet your billing deadlines and get paid sooner

• Import data directly into your accounting system

• Easy access to your bills anytime/anywhere

• Eliminate stacks of paper and envelopes

• Go Green!

Choose Your Delivery Method

1. Email

Receive one email per day that includes a PDF attachment of your statements and/or invoices

from the prior day. You may also choose to receive a downloadable file that will allow you to

easily import your data directly into your accounting system, such as “Quick Books” or “Excel.”

2. Fax

Receive one fax per day that includes all of your statements and/or Invoices from the prior day.

Statements and invoices delivered by Email or Fax look Identical to our paper statements and

invoices. If you have further questions regarding this program, please contact our Billing department

at 302-322-3333.

How to Sign Up

Please email us at billing@unitedelectrlc.com or fax this form to 302-324-3330 and provide us

with the following information:

Customer Name

Account Number

Phone Number

Which delivery method is preferred?

Email address

Fax number

REMIT TO ADDRESS

ATTENTION ACCOUNTS PAYABLE MANAGER

Name: United Electric Supply

Address: PO Box 826788

Philadelphia, PA 19182-6788

Contact Name: Ernest Lupoli

Phone: 302-324-3215

Fax: 302-324-3330

Email: cash.application@unitedelectric.com

DUNS: 00 -249-1512

Email or Fax Delivery Option

As an added service, we offer email or fax delivery of invoices and monthly statements. It is our

preferred method of billing. Please contact a member of our credit team to sign up for this service at

no additional cost to you, the customer (302-322-3333).

We appreciate your use of United Electric Supply as your partner for your electrical needs.

Your suggestions and feedback are always welcome.

Thank you for your continued business.

ACH/WIRE INFORMATION

Dear Valued Customer,

First, thank you for paying via ACH. Paying electronically is both efficient and cost effective.

Below are the wire transfer and ACH routing instructions for United Electric Supply Company:

Financial Institution: PNC Bank, National Association

Address: 500 First Avenue, Pittsburgh, PA 15219

Routing Transit Number: 031100089

Swift: PNCCUS33

Phone: 800-669-1518 option 6

Account Title: United Electric Supply Co Inc

Account Number: 5606440142

Account(s) Type: Commercial Checking

Please contact our Credit Department by emailing us at Credit@unitedelectric.com or

calling us at 302-322-3333 if you have any questions.

We appreciate your business.

Thank you.

United Electric Supply Credit Department

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