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In order for us to serve you better, Now you must read, print, sign and fax this page. 
No credit applications will be approved unless the terms and conditions are signed and faxed to us.  Thank You for your application! A customer service representative will contact you shortly.

Credit Department  FAX: (225) 243-0195 
or 
MAIL: PO Box 99001
             Denham Springs,  LA 70727

PAYMENT TERMS
Deliveries made after the last day of the month will be considered as having been made as of the first of the following month. The invoice total is due net 25th of the month following the month of purchase, and becomes Past Due if payment has not been received by the last day of the month. A service Charge of (the maximum allowed by law not to exceed 1.5% per month, 18% per annum) will be added to Past Due Accounts, and if the account is placed for collection 25% Attorney's Fee plus all expenses, including cost of liens and court costs, will be assessed to the account.

CREDIT APPROVAL
Orders are accepted subject to approval by the Credit Department. Delivery will be withheld and shipment stopped on accepted orders if the available credit information indicates doubt as to the customer's ability to pay in accordance with payment terms.

SELLING PRICE
Merchandise sold will be billed to the customer at the prices in affect on the date of the sale unless a different firm price has been furnished to the customer by written quotation. All non-stock and special purchase items will be billed on an individual basis.
Prices will change periodically as the result of price changes by the manufacturers and as a result of fluctuations in the cost of doing business. The prices are subject to these changes without advance notice.
We reserve the right to refuse an order, or to bill at the correct price, if the billing price is incorrect due to a clerical or mechanical error.

SPECIAL ORDERS
A minimum advance deposit of 25% of the selling price will be required before orders will be placed for special merchandise.

RETURNED GOODS
Merchandise must not be returned for credit without authorization. Returned goods found to have a manufacturer's defect, or goods returned due to an error made by our personnel, or by the manufacturer, will be credited at the invoice price. No consequential damage claims will be honored. If the cause for return lies with the customer, specifier, or any source other than by us or our supplier, we will attempt to minimize the customer's expense or loss, however we will assess a minimum charge of 15% for rehandling the merchandise as well as any transportation or other charges that may have been involved in the sale. Goods authorized for return must be in like new, clean, saleable condition and in its original carton or packaging.

WARRANTY
We make available to our customers the benefits of any warranty terms extended by the manufacturer of that particular item and will aid the customer in obtaining any recovery that may be due. We offer no warranty of any type on any item we sell. We will not be responsible for, nor allow claims for, consequential damages, labor, repairs, lost time, or costs of any kind incident to warranty problems beyond those approved by the manufacturer, and no employee is authorized to modify this policy.

DELAYS
We will not be responsible for delays in delivery caused by any factors beyond our control such as, but not limited to fire, strikes, riots, shortage of material, transportation delays, delays by vendor, etc.

CANCELLATION OF ORDERS
Orders for other than regularly stocked merchandise are not subject to cancellation unless the manufacturer has indicated a willingness to accept the cancellation or return and the customer agrees to all expenses and charges incurred as a result of the cancellation.

DELIVERY
When merchandise is delivered by our vehicle, delivery to the customer takes place at the customer's receiving point. The customer must check for any visible damage upon receipt and if any, notation should be made upon the delivery document and our driver should sign the notation. Packaged goods must be opened and inspected at once, and any concealed damage or shortages should be reported to us immediately. Any materials for which Customer has been billed more that thirty (30) days shall be deemed to have been received by Customer and in suitable condition, unless Customer shall have notified Seller in writing prior to expiration of the thirty (30) day period.
When merchandise is delivered by a common carrier or freight handler, the delivery of the order will be completed at the point at which the signed bill of lading and/or delivery receipt is accomplished. This usually occurs at the manufacturer's or shipper's plant. At that point, the merchandise becomes the customer's property and responsibility. If damages or shortages are determined at the time of delivery, notations must be made on the delivery document and the delivering driver must acknowledge the notation by signing his name under the entry. The customer must then promptly file a claim with the carrier for whatever damages or shortages are involved. Packaged merchandise must be opened and inspected at once. If concealed damages or shortages are discovered, the customer must contact the carrier promptly and request an inspection and a written report. This request must be recorded so that if the carrier fails to make an inspection, this fact can be noted on the claim form.

IN CONSIDERATION OF THE COBURN SUPPLY CO., INC., THE AMERICAN SUPPLY CO., INC., OR ANY OF ITS AFFILIATED DISTRIBUTORS (hereinafter called "Seller"), giving or extending credit to applicant/s, I/WE, the undersigned guarantors, hereby give this continuing and unlimited guaranty to Seller for payment in full, upon demand of any indebtedness, interest, attorney's fees, and charges of whatsoever nature and kind, hereinafter collectively referred to as indebtedness of applicant/s to seller now existing or hereinafter arising.

I/WE, the undersigned, including guarantors, bind and obligate myself/ourselves, heirs, successors and/or assigns, in solido, with said applicant for payment of indebtedness, hereby waiving all notice and pleas of discussion and division.

I/WE, the undersigned, including guarantors agree that this continuing and unlimited guaranty is absolute and complete, expressly waive acceptance and notice thereof by Seller and the same shall remain in full force and effect, until written notice of its discontinuance, but such discontinuance shall not affect my liability for any indebtedness then existing.

I/WE specifically agree that this continuing and unlimited guaranty shall not be in any way limited or restricted because of the monthly amount of credit requested or any credit limit applicable to applicant's account.

I/WE agree that Seller may conduct a credit worthiness inquiry on any or all of the undersigned and may be called upon to furnish to others credit information on the undersigned. I/WE release and hold harmless Seller in such credit information gathering and dissemination. Any false, misleading, or inaccurate answers herein shall not act in any way to relieve or reduce the liability of guarantors.

I/WE, the undersigned, including guarantors, understand that this account is to be paid according to Seller's terms of net 25, and I/WE realize that failure to comply with Seller's payment terms or should any check be returned N.S.F. this will subject this account to being placed on C.O.D. and any credit established could be withdrawn. If Seller employs an attorney or collection agency for collection of indebtedness the undersigned hereby bind and obligate themselves to pay attorney's fees of not less than 25% of the amount of indebtedness due plus expenses and/or any other amounts due in accordance with law. It is further understood that the undersigned agrees to pay a service charge when the account becomes 30 days past due of the maximum allowed by law not to exceed 1.5% per month, 18% per annum.

I/WE AGREE TO ALL OF THE TERMS AND CONDITIONS SET FORTH ON THIS AGREEMENT.

Additional Information Needed

BUSINESS CREDIT INFORMATION

BANK REFERENCES

PROPRIETOR AUTHORIZATION

PROPRIETOR GUARANTEE

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Please print out this form, complete and sign it, and return to Coburn's Credit Department (FAX: (225) 243-0195 or MAIL: PO Box 99001; Denham Springs,  LA 70727 ). We appreciate the opportunity to service you.

Note to Credit Department:  If this customer wants access to their account on-line please e-mail their account # and e-mail address to web_operations@coburns.com