US Logistics

Customer Credit Application

USL Agent You Spoke To:

Company Name:

Business Address:

City:

State:

Zip:

Phone Number:

DUNS #:

Year Company Est'd:

Line of Credit Requested:

Type of Freight (steel, produce, etc):

Other Shipment Details:

Paperwork Requirements

BOL

POD

REF #

Delivery Order

Preferred Invoice Delivery

US Mail

Email Address To Send To:

Special Billing Requirements:

AP Contact Name:

Phone:

Transportation References

Reference Name:

Phone Number:

Email Address:

Reference Name:

Phone Number:

Email Address:

Reference Name:

Phone Number:

Email Address:

Bank Name:

Phone Number:

Bank Contact:

Account Number:

The company agrees to credit terms of PAYMENT UPON RECEIPT of invoice but no longer than 30 days. All invoiced amounts not paid within the 30-day period shall bear interest at the rate of one and one half percent (1.5%) per month. The company agrees to pay any and all reasonable attorneys’ fees, court costs and other expenses incurred by US Logistics LLC in order to collect amounts hereunder. The company agrees to allow US Logistics to run a credit background check and verify all information on this application with any listed parties. The company confirms that all information on this application is accurate. The rights of the parties under this Customer Credit Application shall be governed and interpreted in accordance with the laws of the State of Ohio (without regard to its choice of law provisions). Any claim brought by either party under this Customer Credit Application shall be brought in the courts of the State of Ohio located in Hamilton County or the courts of the United States located in the Southern District of Ohio in Cincinnati, Ohio, and by executing this Customer Credit Application each party hereby irrevocably submits to the jurisdiction of said courts.

Signature:

Title: