CREDIT APPLICATION Business Information Disclaimer: For the purpose of obtaining merchandise and rental equipment on credit, the following made in writing is warranted to be true, intending that you should rely on the same as correct. The applicant hereby authorizes Dahl's Equipment Rentals Inc., and/or its agents to whom this application is made, to investigate/research the references listed herein to ascertain the undersigned personnel, partnership, or corporate credit and financial information. Contact Name: _______________________ Applicant: ____________________________ Business Name: ___________________________________________________________ Address: ____________________________________________________________ Street Address: (if different) ____________________________________________________ Phone No.: __________________________ Fax No.: _____________________________ Business Type: (check one) Corporation Partnership Proprietorship Federal Tax I.D. No: ______________ Please List ALL Owners and/or Corporate Officers: ____________________________________ ____________________________________ Print Name Print Title ____________________________________ ____________________________________ Print Name Print Title ____________________________________ ____________________________________ Print Name Print Title Date Business Started: ___________________ Current Owners Since: ___________________ Former Employment of Owner(s) if Business is Less Than 2 Years Old: ____________________________________ ____________________________________ Company Name From: (month/year)              To: (month/year) ____________________________________ ____________________________________ Company Name From: (month/year)              To: (month/year) ____________________________________ ____________________________________ Company Name From: (month/year)              To: (month/year) Contractor's Licenses Held: State Classification License No.: Name Issued Under _____ _______________________ ___________ _____________________________ _____ _______________________ ___________ _____________________________ _____ _______________________ ___________ _____________________________ Bank Information: Bank Name: _______________________________ Branch: _______________________ Branch Address: ____________________________________________________________ Account Rep. Name: ____________________________ Phone No: ___________________ Checking Account Savings Account Account Number: _______________________ Checking Account Savings Account Account Number: _______________________ Credit Information: Please list credit references with complete company name, address, phone number, and contact: ____________________________________ ____________________________________ Company Name Company Name ____________________________________ ____________________________________ Address Address ____________________________________ ____________________________________ City, State, Zip Code City, State, Zip Code ____________________________________ ____________________________________ Contact Name and Fax Number Contact Name and Fax Number How Did You Hear About Our Company? Yellow Pages (which one?) ____________ Blue Book ThomasNet SDS Communications Dahls Salesperson (name) ___________________ Internet (search engine) ________________ Agreement: The undersigned agrees to all the terms and conditions of sale. Terms and conditions are subject to change without notice. Purchaser agrees to pay all costs of collection, including court costs and all reasonable attorney's fees in case suit or collection action is commenced to collect part or all of the balance on this account. Payment terms are net 30 days, and finance charges are accrued at 1.5% per month on any balance owing past 30 days. Company Name: _____________________________________ Date: _______________ Print Name: _____________________________ Title: ____________________________ Signature: _________________________________________________________________