FacebookThis field is for validation purposes and should be left unchanged.COMPANY DETAILSLegal Business NameDBAEINDate Established Tax Exempt? Yes NoType of Business Sole Propreiertor S Corporation Partnership C CorporationBUSINESS LOCATIONPhysical AddressCountyPhone Country Phone Number ContactAdmin ContactAdmin Contact Email Admin Contact Phone Country Phone Number Service ContactService Contact Email Service Contact Phone Country Phone Number Sales ContactSales Contact Email Sales Contact Phone Country Phone Number Branch ContactBranch Contact Email Branch Contact Phone Country Phone Number ACCOUNTS PAYABLEBilling ContactEmail Phone Country Phone Number Billing AddressInvoices InboxPayment MethodPO Required? Yes NoADDITIONAL LOCATIONSPlease list additional locations below. SALES TAX EXEMPTION MUST BE PROVIDED FOR EACH STATE (TAX WILL BE CHARGED IF CERTIFICATE IS NOT PROVIDED) Additional Location 1Physical AddressPhone Country Phone Number ContactEmail Service ContactService Contact Phone Country Phone Number Service Contact Email Additional Location 2Physical AddressPhone Country Phone Number ContactEmail Service ContactService Contact Phone Country Phone Number Service Contact Email OFFICERS / PARTNERS / OWNERSName 1Title 1Name 2Title 2Principal NamePrincipal TitleOfficers/Partners/OwnersTRADE REFERENCESTrade Reference 1Company NameContactPhone Country Phone Number Email AddressTrade Reference 2Company NameContactPhone Country Phone Number Email AddressTrade Reference 3Company NameContactPhone Country Phone Number Email AddressBANK REFERENCEBank NameContactPhone Country Phone Number Email AddressAcct #ACH INFORMATIONRouting #Account #AR CONTACTNamePhone Country Phone Number AUTHORIZATION PLEASE PROVIDE CERTIFICATE OF INSURANCE, SIGNED W9, AND SALES TAX EXEMPTION (IF APPLICABLE) I certify that the information provided is accurate and current. This statement will act as a release for information regarding the accounts listed above, both trade references and financial institutions. I understand the terms and conditions of American Rental services, LLC and agree to conduct business accordingly and to pay American Rental Services, LLC in accordance with the terms state on the invoice or rental contract. American Rental Services terms are Net 30 unless otherwise specified. The undersigned agrees to pay all collection costs, including reasonable attorney fees, if the account is placed for collection either with or without suit.SignatureDate NameTitleAPPLICATION INFORMATION CUSTOMERS WILL ALSO BE REGISTERED VENDORS WITH ARS ARS REQUIRES A PURCHASE ORDER ON ALL INVOICES. INVOICES MUST BE SENT TO ACCOUNTING@AMERICAN-RENTAL.COM Please return completed application to lisa@american-rental.com.Δ
