Credit Application Form

The undersigned certifies this Commercial Credit Application to be true and correct and is submitted for the purposes of obtaining credit from Cole Industrial & Technical Supply Co., Inc.(CITS), with the understanding that if credit is extended, all purchases, sales, and settlements shall be subject to the approval of CITS. Applicant authorizes CITS to contact references furnished in this application, or any other person or interest, to make relevant investigation regarding Applicant’s credit and/or financial responsibility. All information provided will be held in the strictest confidence.

In consideration of CITS (and all names under which CITS does business, and all its affiliates, parents, subsidiaries and related companies), (hereinafter “Supplier”), extending credit to the Applicant, Applicant agrees to pay for all items delivered to or at the request of the Applicant, net thirty (30) days from the date of invoice for the items so delivered, unless different payment terms have been agreed to in writing by CITS. All accounts are due and payable at the remittance address shown upon the Supplier invoice.

Applicant further agrees that no additional term on a purchase order, either written of verbal, issued by Applicant shall become a part of any agreement, including this Agreement, except to the extent that the purchase order identifies the particular items ordered. Applicant agrees that this Agreement shall govern each sale of an item from Supplier to Applicant. In the event of conflict between the terms and conditions of this Agreement and those stated in the Applicant’s purchase order, the terms and conditions of this Agreement shall govern.

In the event Applicant does not pay the invoices when due, Applicant acknowledges and agrees to pay a service charge at the rate of one and a half percent (1.5%) per month (eighteen percent per annum), but in no event shall service charges exceed the highest amount lawfully allowed under applicable State usury laws. A service charge shall accrue and be assessed on the last day of the month after the original invoice date, and an additional service charge, computed upon the same basis, shall be assessed on the last day of each month thereafter, until such time that the invoice has been paid in full. Supplier’s waiver of any one or more service charge shall not be deemed a waiver of future service charges.

In the case of any default in relation to any transactions between Supplier and Applicant, Applicant agrees and shall pay Suppler its reasonable attorneys’ fees and costs incurred therewith, regardless of whether an action is filed, including without limitation costs related to collection, arbitration, trial, and for any special review or reconsideration thereof, and any such fees or costs incurred after any award or judgment has been entered.

Jurisdiction and venue for any legal action arising from or related to this Agreement shall be Hillsborough County, Florida. Florida law shall control and govern any such dispute without resort to conflict of law principles. Applicant authorizes Supplier to obtain credit and financial information concerning Applicant at any time and from any source for the purpose of evaluating Applicant’s creditworthiness in connection with this Agreement.

Any misrepresentation in this application will be considered evidence of fraud, since this information is the basis for the extending of credit. As an inducement to grant credit, the undersigned warrants that the information submitted is true and correct. You are authorized to investigate the credit references and principals listed. In consideration for the extension of credit, said business promises to pay for all purchases within the terms agreed (Net 30) and agrees to pay a service charge per month of 1-1/2% per month (18% annual percentage rate) on all past due balances. In the event any third parties are employed to collect any outstanding monies owed by said business the undersigned agrees to pay reasonable collection costs, including attorney fees, whether or not litigation has commenced, and all costs of litigation incurred. The undersigned represents that he/she has the authority to execute this credit agreement on behalf of the business identified.

In consideration for Cole Industrial & Technical Supply extending credit to the business identified below for any materials and/or services after this date at the request of applicants or its agents, the undersigned individual hereby personally guarantees unconditionally and irrevocably the prompt payment of any sums now or hereafter owed to the supplier by the business identified below whether said sums are due under open account, contract or otherwise. It is understood and agreed that credit, if extended, is to be on a continuing basis and may exceed estimated maximum credit limit required as stated in the credit agreement between the supplier and the applicant / business. The supplier shall not be obligated to notify the undersigned of the dates or amounts of any such credit and the undersigned waives demand, notice of default and any extension of time or any other forbearance which may be extended by the supplier. This guaranty shall continue in force until notice in writing, sent by registered or certified mail, return receipt requested is received by the supplier. Said notice shall specify the date on which this guaranty is to be terminated, said date not to be less than seven days after such notice is received. Such termination shall in no way release the undersigned as to any sum or debt incurred prior to such termination.