GORDON GRAVEL & STONE LLC. Credit ApplicationCall us with any questions.We’re here to help.(603) 325-8457 There was an error trying to submit your form. Please try again. Name/Address/Company Info Last Name This field is required. First Name This field is required. Name of Business This field is required. Tax ID # Year Started State of Incorporation This field is required. Federal ID # This field is required. Address This field is required. City This field is required. State This field is required. Zip Website Address This field is required. Dun & Bradstreet # This field is required. Email This field is required. Phone # This field is required. Sole Proprietor LLC Corporation A/P and Terms Do you require a PO# before we accept an order? Yes No A/P Contact This field is required. A/P email This field is required. A/P Phone This field is required. Estimated Monthly Purchases This field is required. Terms Requested COD Credit Card Net Terms - Credit Limit Requested $ Bank/Trade References Bank Name This field is required. Account # This field is required. Bank Number This field is required. Bank Name This field is required. Account # This field is required. Bank Number This field is required. Trade Reference - Company & Contact Person This field is required. Phone Number This field is required. Trade Reference - Company & Contact Person This field is required. Phone Number This field is required. Signature I Certify: By checking this box and providing my name below, I affirm that all information provided in this credit application is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in the rejection of this application or other legal consequences. My legal name and today's date. This field is required. Application Consent You represent yourself as an authorized representative with authority to enter into this agreement. The information contained in this Application and any attachment is true, correct, and complete. You consent to the Vendor obtaining information about you personally and the Applicant from credit reporting agencies and other sources Vendor deems appropriate in considering this Application. If credit is extended, you agree to be bound by all terms and conditions on Vendor’s invoices and posted on Vendor’s website. Submit There was an error trying to submit your form. Please try again. EMAILgordonservices@ymail.com LOCATION250 North Street, Jaffrey NH 03452 PHONE NUMBER(603)325-8457
