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DGI Credit Application

  • Please fill in all required fields, marked with an asterisk (*).
  • If you would like to fill out the paper version of this application, you may fax it to 847-484-2045.
  • This application will take X days to process, maximum. Until you are approved, any orders against your Open Account will be held in processing.

REQUIRED fields are marked with an asterisk (*).

Company Information
   
   
 
   
   
 
Billing Address
 
 
 
 
 
   XXX-XXX-XXXX
   
Sales Contact
   
   
Accounts Payable Contact
   
 
Owner of Company
   
   
 
   
 
 
   XXX-XX-XXXX
   XXX-XXX-XXXX
   XXX-XXX-XXXX
Person Authorized to Purchase Goods on Behalf of Company #1
   
   XXX-XX-XXXX
Person Authorized to Purchase Goods on Behalf of Company #2
   
   XXX-XX-XXXX
Credit and Trade Reference #1
   
   
 
   
 
 
   XXX-XXX-XXXX
   
Credit and Trade Reference #2
   
   
 
   
 
   XXX-XXX-XXXX
   
Bank Reference
   
   
 
   
 
   
 
Agreement

DGI MAKES NO WARRANTY, EXPRESS OR IMPLIED, THAT PRODUCTS ARE MERCHANTABLE OR FIT FOR A PARTICULAR PURPOSE, OR THAT PRODUCTS WILL CONFORM TO ILLUSTRATIONS OR DESCRIPTIONS. ANY LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES IS EXPRESSLY DISCLAIMED. DGI's liability is limited to, and in any event will not exceed, the purchase price paid. All returns must be authorized in advance and may be subject to a restocking charge. DGI does not guarantee compliance with any state or local codes and regulations governing suitability of products, and is not responsible for how the products are installed or used. DGI makes no warranty with respect to the contents of any product literature, and DGI reserves the right to change prices or modify any catalog or brochure at any time. State and local tax will be charged unless a sales tax exemption certification has been provided to DGI. Payment, in U.S. Dollars, is due upon delivery. Credit terms, if approved, are 30 days from date of invoice. Purchaser agrees to return, upon demand by DGI, any merchandise for which payment has not been timely tendered. Purchaser agrees to reimburse DGI for the cost, including attorneys fees or other charges, incurred to collect any amounts past due. Purchaser agrees to pay DGI interest at the rate of the lesser of (i) 1.5% per month or (ii) the highest interest rate permitted by applicable law for any outstanding indebtedness to DGI (including expenses of collection) which is not timely paid. Purchaser agrees to operate the products purchased in a safe manner, not remove or alter any safety features of the product and indemnify and hold DGI harmless from any claim or liability resulting from actions with respect to the product. Failure to immediately return the merchandise described herein constitutes conclusive acceptance of the merchandise and of these Terms and Conditions. The information given above is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize DGI Company, its affiliates, nominees, agents, and attorneys in fact or law to investigate and verify all of the above information including all trade, credit, and banking references.


   
   
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* All specifications, designs and pricing are subject to change without notice and DGI Supply reserves the right to correct errors which may appear on this website.