Shipping Address

Billing Address

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Company Size

Business References

Major Product Lines including Address and Phone Number:

Bank Reference (Major):

Federal Excise Tax Exemption:

Submitted by:

Payment Terms:

2% 10th, Net 30th

Terms of Sale: The undersigned agrees to pay before the due date according to the terms of sale stated above and on each invoice. Any unearned discounts will be disallowed and charged back. GB&C is not obligated to process or ship any orders to accounts with an outstanding past due balance. The undersigned agrees to abide by the above-stated terms and conditions, and further agrees to pay and reimburse GB&C for all costs and expenses, including reasonable attorney’s fees, incurred by GB&C, in connection with: (1) collection of any indebtedness as a result of GB&C’s agreement to grant credit to make purchases. (2) the protection or realization of any collateral securing such indebtedness.

The undersigned verifies that the statements in this application are true and accurate.

The undersigned authorizes trade and bank references to release information to GB&C.

Personal Guaranty of Company Account:

The undersigned absolutely and unconditionally guarantees the full payment of debt relating to the account of Company Name, which may now or hereafter become due and owing as a result of shipment of goods by Gorilla Brake & Components to aforesaid company. The undersigned agrees to pay reasonable costs and expenses of enforcement and collection of the obligation under this agreement including reasonable attorney fees and court costs.

In witness whereof, I have signed my name on and by doing so, agree to the terms of this Guaranty.



Gorilla Brake & Components

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