JUST GREAT PRODUCE, LLC CREDIT APPLICATION                                                          413-789-0790
PO BOX 4645
SPRINGFIELD, MA. 01101
                                                                    BILLING AND SHIPPING ADDRESS
BILLING ADDRESS:                                  SHIPPING ADDRESS:
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LEGAL BUSINESS NAME ADDRESS
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(DBA) TRADE NAME CITY, STATE, ZIP
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ADDRESS SALES CONTACT AND PHONE #
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A/P PHONE # A/P FAX SALES PHONE # SALES FAX # SALES E-MAIL ADDRESS

BUSINESS PROFILE
______Proprietorship ______ Partnership ______ Corporation ______ LLC or LLP ______ Years in Business

Date of Incorporation ____________ State of Incorporation __________ Type of Business _____________ F.I.N. _________________________

PRINCIPALS OR OFFICERS OF THE CORPORATION

NAME ______________________________________ TITLE _____________________ SOCIAL SECURITY NO. _____________________________________________

RESIDENCE ADDRESS __________________________________________________ PHONE _____________________________________________________________

NAME ______________________________________ TITLE _____________________ SOCIAL SECURITY NO. _____________________________________________

RESIDENCE ADDRESS __________________________________________________ PHONE _____________________________________________________________

TRADE REFERENCES
List firms with one (1) year experience where applicable (Food Distributors Preferred)

1. NAME __________________________________________ ADDRESS ________________________________________________________________________________

CITY _____________________ STATE ______ ZIP ___________________________ PHONE ( ) ____________________________________________________

ACCOUNT # __________________________________ CONTACT __________________________________________________________________________________

2. NAME __________________________________________ ADDRESS ________________________________________________________________________________

CITY _____________________ STATE ______ ZIP ___________________________ PHONE ( ) ____________________________________________________

ACCOUNT # __________________________________ CONTACT __________________________________________________________________________________

BANK REFERENCES

NAME ___________________________________________ ADDRESS ________________________________________________________________________________

CITY _______________________ STATE __________ ZIP ___________________ PHONE ( ) ____________________________________________________

ACCOUNT NUMBER _________________________________________ CONTACT _____________________________________________________________________

THIS AUTHORIZES YOU TO RELEASE INFORMATION ON MY ACCOUNT TO JUST GREAT PRODUCE LLC 

WRITTEN SIGNATURE _________________________________________________________ DATE ____________________________________

PACA REGULATIONS REQUIRE PAYMENT WITHIN 10 DAYS FROM ACCEPTANCE OF THE PRODUCE unless there is a written agreement increasing the time for payment. Payment terms cannot be extended beyond 30 days from acceptance of product. Upon approval of this application and in event that the applicant will be offered payment terms in excess of 10 days, the applicant will be mailed a credit terms agreement stating the payment terms. This agreement must be signed by the applicant and returned before product will be sold.
I/We agree that if our account becomes delinquent I/we shall pay the entire amount due plus collection costs and reasonable attorney’s fees. Additionally, I/we agree to pay a 1.5% service charge per month on all unpaid balances. All payments received will be applied to the oldest balance first. The parties hereto knowingly waive the right to a jury trial on any issue or dispute that may arise between them. The undersigned acknowledges that this agreement evidences a commercial transaction as that and 52-2781, the undersigned hereby waive his rights to notice and hearing prior to the issuance by Just Great Produce, LLC of any pre-judgement remedy, and the undersigned further waives any rights as may exist under federal law to any notice and/or hearing prior to Just Great Produce, LLC obtaining and exercising any pre-judgement remedy. The laws of the State of Massachusetts shall apply to all suits arising under any agreement between the undersigned and Just Great Produce, LLC. The undersigned authorizes Just Great Produce, LLC to use outside credit reporting services to obtain credit information. Terms and conditions: No item shall be accepted for return without prior approval.
I certify that all the information on this form is correct. I understand your credit terms and agree to prompt payment in consideration for extended credit.

NAME _________________________________________________ SIGNED ____________________________________ DATE ________________

TITLE __________________________________________________ WITNESS ___________________________________ DATE ________________

PLEASE FILL IN INFORMATION ON BOTH FRONT AND BACK OF THIS APPLICATION



Personal Guarantee: I,________________________________________, in consideration for the extension of credit to ____________________________, (the “Company”), hereby personally and unconditionally guarantee all debts and obligations of the Company due Just Great Produce,LLC. This guarantee is continuing and irrevocable. I hereby waive notice of default, non-payment and notice thereof and the right to a jury trial. I consent to any modification or renewal of the credit hereby guaranteed. I hereby consent to apply Massachusetts’s law to the interpretation and enforcement of this Guarantee. I hereby waive and release all rights of subrogation, reimbursement and indemnity against the Company. This guarantee applies to all payments which are rescinded or restored under state insolvency or federal bankruptcy laws.


The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, or age (provided that Applicant has the capacity to enter into a binding contract); because all or part of Applicant’s income derives from any public assistance programs; or because Applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning the creditor is the Federal Trade Commission, Washington, D.C.

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Witness Signed (Individually and as the Duly Authorized Representative of the Co.)

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Date Printed Name

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Residence Address

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State Zip




OUR NORMAL CREDIT TERMS ARE 10 DAYS