Credit Application

Required fields for credit application are denoted with a red asterisk below.

Credit Application Type * Company Name * Company Address *

Company City *

Phone Number *

Company State *

Years in Business *

Company Zip Code *

Duns#

Type of Ownership

Corporation

Partnership

Sole Proprietor

Billing Address *

Billing Address is the same as Company Address

Billing Email Address *

Bank Reference 1 *

Bank Name * Account number * City * State * Phone number * Contact Name * Contact Email *

Bank Reference 2

Bank Name Account number City State Phone number Contact Name Contact Email

Trade Reference 1 *

Name * Account number * City * State * Phone number * Contact Name *

Trade Reference 2 *

Name * Account number * City * State * Phone number * Contact Name *

Requested Credit Limit $ * Armstrong Sales Representative name *

By clicking the checkbox below, you and your company acknowledge, accept, and agree to be legally bound by Armstrong Transportation Management’s Terms and Conditions of Service.

By submitting this application and executing this agreement, you and your company acknowledge, accept, and agree to the following:

Consent is provided by the company to Armstrong Transportation Management to do business and execute legally binding documents electronically. The company may opt out of and withdraw consent to electronic signatures and documents only by written notification of same to Armstrong Transportation Management.
The foregoing information was provided to obtain an open account status with Armstrong Transportation Management.
The person submitting this application and executing this agreement certifies that the foregoing information is complete, accurate, and true to the best of his/her knowledge.
The person submitting this application and executing this agreement has full authority to legally bind the company he/she represents, including without limitation acceptance of Armstrong Transportation Management’s Terms and Conditions of Service, and is authorized by the company to enter into the credit application process.
The person submitting this application and executing this agreement acknowledges and agrees that clicking the checkbox below, entering his/her name and information into the fields below, and clicking the submit button is as equally and legally binding as if he/she completed a handwritten signature and paper contract.
Full permission and authorization is granted by the company to Armstrong Transportation Management to inquire about the company's credit worthiness from any source, including without limitation all references provided in this application.
Full payment of Armstrong Transportation Management invoices is due fifteen (15) days from the date of receipt unless otherwise indicated.
Armstrong Transportation Management shall charge a two percent (2%) per month late fee for unpaid invoices and balances.
In any dispute involving monies owed to Armstrong Transportation Management, Armstrong Transportation Management shall be entitled to all costs and expenses of collection, including reasonable attorney's fees and interest at 15% per annum or the highest rate allowed by law, whichever is less.

Authorized Signatory *

(Note: Application must be signed by person with authority to bind your company)

Signatory Title * Signatory Email *

Please check the box below to proceed.