Advanced Network Systems Confidential Credit Application

Establishing Your Account

Thank you for choosing Advanced Network Systems. As our customer, you will have access to our carefully selected portfolio of best-in class products and a variety of support programs and services designed to help you build the right technology infrastructure. We look forward to working with you and supporting your organization’s operations with the industry’s finest voice, data and video network solutions.

This application document is designed to save you time and help us manage your request for credit terms more efficiently. Before submitting your application for credit terms, please review the following explanation of the application process and the application checklist provided below.

The Credit Terms Application Process

All customer applications for credit terms are subject to review and approval by Advanced Network Systems.
Please allow at least 3 business days for processing of your completed application.
Applications must be completed and approved by a duly authorized officer, partner, member or individual.
Incomplete credit applications (those with missing authorization, incomplete or inaccurate reference contact information, etc.) will delay the review process and, in turn, effect the processing of your order.
Questions can be answered by contacting our Credit Processing department at 800.639.6757, between 8:00 a.m. and 5:00 p.m., Eastern Time.
Upon credit approval, your account with Advanced Network Systems will be established.

If your application is not approved, pre-payment may also be made via the following means

Credit card —MasterCard, Visa, or American Express
Wire transfer/EFT
Company or Cashier’s check

All sales are subject to Advanced Network Systems Sales Terms and Conditions.

Other Required Items

The following is a list of additional items, if applicable, which you will need to provide to Advanced Network Systems in order to establish your account:

Sales and Use Tax Certificate of Exemption – An appropriate certificate of exemption must be provided, upon establishment of your account. This documentation should be furnished to Advanced Network Systems along with your application for terms, credit card processing payment form, or prior to our receipt of any other form of payment. All applicable taxes for goods and services will be applied to—and thus due and payable on—your order unless this documentation is supplied. Tax certificates will not be accepted unless all requested information is complete. Please include your company’s legal name and D/B/A on all tax forms.

Alternate Financing- If your purchase is going to be financed through a third party leasing company, you must provide Advanced Network Systems with the company name, address, phone number and a contact person for the leasing organization. Alternatively, Advanced Network Systems offers end-user leasing programs to provide you with the opportunity to receive the financial support you need; please contact your Sales Representative for more information.

Credit Card Purchases – If you choose to use a credit card for payment, please include a copy of our Credit Card Payment Form. Credit card purchases are subject to credit card processor’s approval.

Credit Terms Application

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Billing Information

Full Legal Business Name:
DBA or AKA:
Your email address:
Business Phone:
Business Fax:
Delivery Address (cannot be a PO Box)
Billing Address: (if different than above)

Business Credit Information

Principal or Authorized Co.Officer:		(title)
Contact person for this account:		(title)
Accounts Payable contact:		(title)
Primary Business Type:
In business since:
Number of Locations:
Number of Employees:
Federal ID number:
Dun & Bradstreet number:
Tax Exempt?	yes no
Resale Tax ID number:		(Resale Certificate must be submitted by fax to 434.973.9322 for exemption to apply)
Company type:	Proprietorship Partnership LLC Corporation
If Incorporated, under the law of what state?

Trade References

(a minimum of three references is required)

Vendor 1 Name:		Contact:
Address:
Phone:		Fax:
Vendor 2 Name:		Contact:
Address:
Phone:		Fax:
Vendor 3 Name:		Contact:
Address:
Phone:		Fax:

Bank References

Bank Name:		Contact:
Bank Address:
Bank Phone:		Bank Fax:
Checking Account Number:		Saving/MM account number:

Authorized Contacts for Your Account

Name:		Title:
Name:		Title:

AUTHORIZATION: I hereby represent that I am authorized to submit this application on behalf of the company named above "my company," and that the information provided is for the purpose of obtaining credit and is warranted to be true. The submission of this information is not, however, to be construed as a granting of open account terms, as this decision is reserved by Advanced Network Systems, Inc. I hereby authorize Advanced Network Systems, Inc. to investigate the references listed pertaining to my company's credit and financial responsibility, and to obtain a written or oral credit report on its credit from any credit reporting agency. I authorize any bank, other financial institution or commercial business with whom my company is doing or has done any type of business to give any and all necessary information to Advanced Network Systems which will assist Advanced Network Systems in arriving at a credit decision.

TERMS/COLLECTION COSTS: Title to all merchandise invoiced hereon shall pass to my company only upon full payment of Advanced Network Systems’ invoice. If the invoice is not paid within the specified payment period negotiated between Advanced Network Systems and my company, the overdue amount will be subject to late fees and collection. My company agrees to pay interest at the rate of 18% per year (or state maximum) on any overdue amounts. If an account is forwarded to an attorney for collection, my company also agrees to pay all costs, including reasonable attorney's fees.

RIGHT TO REDUCE OR TERMINATE CREDIT: Should my company, at some future time, deviate from Advanced Network Systems' credit terms, Advanced Network Systems reserves the right to terminate future extension of credit to my company. If my company's account should become delinquent or exceed the established credit limit set by Advanced Network Systems, Advanced Network Systems may ship my company's orders C.O.D. or hold them until payment is received to bring my company's account to a current status. If there is any change in my company's status (name, address, principals, tax number, etc.), another authorized person or I must give Advanced Network Systems prompt notification in writing, and may have to complete a new credit application.

ABILITY AND WILLINGNESS TO PAY: I hereby apply for credit in accordance with the terms above and intend you should rely on my representations as correct. I further represent that the company applying for credit has the financial ability and willingness to pay all invoices with the established terms.

By entering my initials in the box below I acknowledge that, as an authorized representative of the company, I have read and agree to all the terms and conditions set forth above as well as the terms and conditions of the agreement set forth on this linked page.