Application Form for Waiter - PDF - PDF

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Application Form for Waiter - PDF - PDF Powered By Docstoc
					                                          CORPORATE ACCOUNT APPLICATION
                                             Waiter.com, Inc. * 453 Ravendale Drive, Suite A * Mountain View, CA 94043

You can order from us without the hassle of charging your own credit card, using petty cash or getting a
check from accounting. Simply complete this Corporate Account Form with the information below and
fax it to us. Account requests will be evaluated and we will contact you upon approval with your
account number. Please PRINT all information.
                                    DELIVERY INFORMATION
Your Name: ______________________ Company:
Phone Number: (                 )               __ Waiter.com UserName:___________________
E-MAIL ADDRESS (IMPORTANT):
Authorized Users:
Delivery Address:                                                            Bldg/Suite:
Cross Street:_______________ City:                                          Zip Code:

                                        ACCOUNTS PAYABLE
Address:
Phone Number: (                 )                                                        Ext:
Fax Number: (               )                            Email Address:______________________
Contact Person:
Send Our Bill By: [ ] Email [ ] U.S. Mail [ ] Both                   Send Our Bill: [ ] Daily [ ] Bi-Weekly
                                       TERMS & CONDITIONS
•   DIRECT BILLING - INVOICES ARE PAYABLE 10 DAYS FROM RECEIPT
•   SERVICE CHARGE & 15% DRIVER SUPPORT CHARGE ADDED TO ALL ORDERS
•   Late Payment / Default Clause. Account holder shall be responsible for a finance charge of 1.5% per month
    for all unpaid balances in excess of 30 days. If the account is placed with a collection attorney, the account
    holder shall be responsible to pay all court costs as well as a reasonable attorney fee.
      ***PLEASE INCLUDE A LIST OF FOUR CREDIT REFERENCES***

Your NAME:                                                       TITLE:
SIGNATURE:                                                           ____________________________
Phone: (          )                                 Fax Number: (              )                          _____
Num of Employees:                                   Year Business Started                        ______
How did you hear about us? _______________________________________________



                                                                                       MKT CODE: CDCWEB

				
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