1300 Petaluma Blvd N. ● Petaluma, CA 94952 ● Phone 707-763-5665
240 Francisco Blvd W. ● San Rafael, CA 94901 ● Phone 415-884-0610
35 N. Amphlett Boulevard ● San Mateo, CA 94401 ● Phone 650-777-3535
APPLICATION FOR CREDIT
Account Name__________________________________________________________________________
Street Location __________________________Mailing Address__________________________________
City/State/Zip__________________________________________________________________________
Area Code/Telephone ______________________Area Code/Fax__________________________________
Email__________________________________________ Federal ID______________________________
How would you like to receive your invoices and statements? ( ) Email ( ) Fax
Business Information
Type of Ownership: ( ) Individual ( ) Partnership ( ) Corporation ( ) Other
Description of Business ______________________Contractors License#___________________________
Contact Name______________________________ Amount of Credit Desired_______________________
Years in Business__________ General Liability Insurance Carrier_________________________________
Have you ever filed for Bankruptcy? ( ) No
( ) Yes, Date Filed _________________________________Chapter Filed___________________
Ownership Information
Name and Title (Sole Owner-Partner-Officer) _________________________________________________
Current Address ____________________________Social Security #_______________________________
City/State/Zip _____________________________Area Code/Telephone___________________________
Name and Title (Sole Owner-Partner-Officer) _________________________________________________
Current Address_________________________________________________________________________
City/State/Zip _____________________________Area Code/Telephone___________________________
Bank Reference
Bank and Branch_______________________________Phone____________________________________
Contact Name__________________________________________________________________________
Account Number___________________________( ) checking ( ) savings
Trade References: (list open accounts only.)
1) Name _______________________________ Contact Name___________________________________
Phone Number__________________________ Fax Number_____________________________________
Account Number________________________
1300 Petaluma Blvd N. ● Petaluma, CA 94952 ● Phone 707-763-5665
240 Francisco Blvd W. ● San Rafael, CA 94901 ● Phone 415-884-0610
35 N. Amphlett Boulevard ● San Mateo, CA 94401 ● Phone 650-777-3535
Trade References (continued)
2) Name _______________________________ Contact Name___________________________________
Phone Number__________________________ Fax Number_____________________________________
Account Number________________________
3) Name _______________________________ Contact Name___________________________________
Phone Number__________________________ Fax Number_____________________________________
Account Number________________________
Damage Waiver Accepted? ( ) Yes ( ) No – If no, we need a current insurance certificate (See Below.)
Restrict use of account to Purchase Order Numbers? ( ) Yes ( ) No
And/Or to Authorized Users? ( ) No ( ) Yes – Please list persons authorized to use this account
______________________________________________________________________________________
______________________________________________________________________________________
We charge a damage waiver covering accidental damage to our equipment/vehicles. To decline
damage waiver, please attach the required certificate of insurance with the following:
1. Cal-West Rentals, Inc as additional insured on your general liability insurance.
2. Inland Marine or Equipment Floater coverage that includes leased or rented equipment and must
equal or exceed the value of the rented items.
If equipment is rented for more than four weeks, renewal billing will be issued by unsigned invoices.
All such invoices are due and payable net 30 from date of invoice.
The undersigned gives Cal-West Rentals, Inc. permission to use and verify the above-stated
information, including, but not limited to, obtaining a consumer credit report from any consumer
reporting agencies, in considering this application for credit, for the purpose of update, renewal, or
further extension of credit, and/or for review or collection on the account, at any time. Upon written
request, Cal-West will provide the undersigned with the name and address of each consumer
reporting agency that Cal-West obtained a consumer credit report from relating to the above-named
applicant.
In consideration of credit extended by Cal-West for equipment, materials, services, etc., furnished
or to be furnished to the Applicant, the undersigned hereby certifies, verifies and agrees that (i) all of
the above-stated information is true and correct, (ii) the Applicant shall pay Cal-West’s invoices in
a timely manner in accordance with the terms thereof, including interest at the maximum legal rate
on any invoiced balance due not paid when due, (iii) the Applicant shall pay all reasonable attorney’s
fees and other costs of collection incurred by Cal-West (or its assigns) to collect on any unpaid or
past due invoice owed by Applicant, and (iv) if Applicant is an entity, the undersigned is duly
authorized to act, represent and enter into agreements on behalf of the entity, including, but not
limited to this application, and shall personally guarantee applicant’s payment and other
performance under the terms of this application, any rental agreement(s) with Cal-West, and any
invoices for equipment, vehicles, services, materials etc., furnished to or for the benefit of the
applicant by Cal-West, which guarantee shall be unconditional and continuing for all unpaid invoices
and other obligations owed by Applicant to Cal-West from time to time.
3. Please remit payment to 1300 Petaluma Blvd N., Petaluma CA 94952.
SIGNED (Must Be Officer, Partner, or Sole Owner) ___________________________________________
Name and Title______________________________________________________Date_______________
