CREDIT APPLICATION
Jacksonville Duval County 904-346-1266
St Augustine St Johns County 904-824-7144
Orange Park Clay County 904-264-6444
Jacksonville Beaches Duval County 904-246-3969
Fernandina Nassau County 904-277-3040
Macclenny Baker County 904-259-5091
Palm Coast Flagler County 386-439-5290
Daytona Volusia County 386-253-4911
Serving all of Florida and Georgia at 904-346-1266
EMAIL LARRY@1STPROP.COM (feel free to email your bidding packages here)
ASAP Plumbing & Drain Cleaning Company
ASAP Tile Installers
ASAP IRRIGATION
ALL PRO GAS
ALL PRO PLUMBING
ASAP ROOF AND INSPECTION SERVICES
ASAP GENERAL CONTRACTING
ASAP BACKFLOW
Thank you,
Credit Department
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ASAP COMPANYS
CAN SERVICE THE FOLLOWING
COUNTIES IN NORTH EASTERN FLORIDA
ALACHUA, BAKER, BRADFORD, CLAY, COLUMBIA, DIXIE, DUVAL,
FLAGLER, GILCHRIST, LEVY, NASSAU, PUTNAM, ST JOHNS, UNION
AND IN SOUTH EASTERN GEORGIA
CAMDEN AND CHARLTON COUNTIES.
Additional services that we offer
* PLUMBING
*DRAIN CLEANING
*COMMERCIAL REMODELING
*PUMP REPAIR
*HIGH PRESSURE WATER JETTING FOR SEWERS
*SHOWER STALLS AND PANS
*TOTAL BATHROOM REMODELING
*LIFT STATIONS
*TILE INSTALLATION AND REPAIRS
*DRYWALL REPAIRS
TV VIDEO SEWER CAMERA
* BACKFLOW TESTING AND CERTIFICATION
PO BOX 48070
JACKSONVILLE, FL 32247
Fax (904) 346-0770
CREDIT APPLICATION
ASAP PLUMBING AND DRAIN CLEANING COMPANY
FIRST NAME LAST NAME TELEPHONE
( )
BILL TO ADDRESS CITY STATE ZIP
NAME AND ADDRESS OF PARENT COMPANY, IF SUBSIDIARY/DIVISION
HOW LONG IN BUSINESS _________ FULL OR PART TIME ________ IF PART TIME, PLACE OF EMPLOYMENT _______________
TYPE OF BUSINESS
CREDIT LIMIT REQUESTED NAME OF CONTROLLER ACCOUNTS PAYABLE CONTACT
( ) CORPORATION ( STATE OF INCORPORATION_____________ ) ( ) PARTNERSHIP ( ) SOLE PROPRIETOR
PROPRIETOR, PARTNERS, OR OFFICERS
NAME HOME ADDRESS
NAME HOME ADDRESS
NAME HOME ADDRESS
TRADE REFERNCES
NAME__________________________________ ADDRESS_____________________________________ TELEPHONE ( )____________________
ACCOUNT NUMBER ___________________ CITY________________________ STATE ____________ ZIP _________________
NAME__________________________________ ADDRESS_____________________________________ TELEPHONE ( )____________________
ACCOUNT NUMBER ___________________ CITY________________________ STATE ____________ ZIP _________________
NAME__________________________________ ADDRESS_____________________________________ TELEPHONE ( )____________________
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ACCOUNT NUMBER ___________________ CITY________________________ STATE ____________ ZIP _________________ BANK NAME ADDRESS
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ACCOUNT NO. CITY STATE ZIP
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forward to doing business with you.
CREDIT APPLICATION
A) The attached credit application is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize the firm to whom this application is made to investigate the reverences listed pertaining to my/our credit and credit responsibilities. I/We authorize the release of information from the above-mentioned companies in regards to my/our payment history.
B) I/We personally guarantee that all bills submitted to me will be paid within 60 days of service. I also agree in advance that if I fail to pay within 60 days of service that ASAP is authorized to charge my credit card.
Card Number ________________________________________________
Expiration Date _____________________________
C) This agreement authorizes ASAP Companies and it’s subsidiaries and affiliated companies to do maintenance service on my properties, which I own and/or manage on behalf of someone else. This agreement authorizes my employees to call in service orders on behalf of me and/or my company and/or affiliated entities.
D) This agreement may change from time to time. ASAP will notify you via regular U.S. mail of any changes in the agreement with a minimum of 30 days notice. This agreement shall incorporate all conditions, guarantees, warranties, and statements found on the FIELD COPY that our technicians use at time of service.
E) I/We have read the above and agree to all terms and conditions.
Owner’s signature _______________________________ Title__________________________________________
Or owner’s representative
Print Name___________________________________________________________________
Driver’s License Number and State _______________________________________________
Date ____________________________