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Home My WebLink AboutTiffany Lawn & Garden Supply - Credit Application b P OFFICE USE ONLY 1.,2\NN LAWN & GARDEN SUPPLY. INC. BUYER'S CREDIT APPLICATION AND OPEN ACCOUNT AGREEMENT For the purpose of establishing open account privileges,the undersigned furnishes the following information: Seller's Name: Tiffany Lawn and Garden Supply, Inc.,4931 Robison Road, Indianapolis, IN 46268, Phone: 317-228-4900 Buyer's Name: C'/•-) o�eu/ ' '/ �pe/ee/P�,yr>�v7 ntcipated Monthly Purchases:$ 17'(7° Company Trade Name Business Phone Number(31 ) S 7/ 279 5' Business Address 3d 4/- 4 5 4i 52i7 ' 22-0 Business FAX Number( City Ce, 1-071/ State/Zip / r'&i30E-Mail Address p/c(�e/ cer/-- rl/‘ii fa 1./ Billing Address 3C4 ' St, .556'/%4' 220' Tax Exempt? (G'' )Yes ( ) No City (0'e-iffy/ State/Zip /v 4'53(1 If Tax Exempt, Please attach Tax Certificate Type of Business: Corporation( ) Partnership( ) LLC( ) Sole Proprietorship ( ) Limited Partnership( ) 60,e/w/0,- 71 ONer /0,- 71 If Incorporated, State in which Incorporated Year Incorporated Alco' r°-' Y Names of Owners, Partners, or Officers: Name Title Residence Address Home Phone Number Social Security Number 1. �� l y 01G l Jr`lir/, /42 2. 3. / Name of Accounts Payable Representative D,J, C!w r/ , / Phone Number .37 7—5-7/-2795-- Name and Location of any other Businesses Owned Banking Information: Name of Bank Branch Address Phone Number Checking Account Number Name of Bank Representative Savings Account Number Loan Account Number How is Loan Secured? Monthly Payments? Balance? ALL FIELDS FOR SUPPLIERS ARE REQUIRED Principal Suppliers: Name //// Phone Number Fax Number Balance owed? 1. /1T6r/k0/ 2. 3. 4. 5. Have you given any of the above a personal Guaranty? ( )Yes (V) No If So,To Whom? If Branch or Division, Location of Home Office Phone Number( ) Do You Require Purchase Orders? ( Yes ( ) No Building( ) Leasing( ) Buying( ) Monthly Amount of Payment? Name/Address of Landlord/Mortgagee Is the buyer currently in a Bankruptcy Proceeding,or has the buyer filed a Voluntary Bankruptcy, or had an Involuntary Insolvency Proceeding filed against it within the last 14 years? Are you currently a party to any lawsuit, or are there any outstanding judgments against the buyer? Yes ( ✓) No If the answer is yes to either, please explain on a separate sheet. ' TERMS AND CONDITIONS: 1 . • . . . . • • • • • .•_time. In the event p. •• - - - -- - - - - --- - -- . ••- - •.. .• _ • _- • -- - - - •_ - -°. .- -=(24%per annum)or the maximum lawful rate on all overdue amounts,and to pay all collection costs incurred by seller in enforcement of the terms-2;..and— '. . . ..'. . . • •..+ .. .mn• - - • e•-•7.- lI witlront-relicf f1oi --va+uation-and app,ai cmcl,t laws. li/ jf m07t J 45 7xj`-/L O iI- Cr' �lr//s_ If legal action becomes necessary by either buyer or seller,the buyer agrees that this or any contemporaneous or subsequent agreement will be governed as to validity,interpretation,construction,effect and all other respects by laws of the State of INDIANA . Buyer further agrees that in the event legal action becomes necessary by either buyer or seller,jurisdiction and preferred venue shall remain in ,in the state of INDIANA. Buyer further agrees that any line of credit desired or approved is not a limitation of liability,and the undersigned expressly agrees that it will be responsible for valid charges in excess of a line of credit either desired or approved. Having obtained all necessary authority,the undersigned authorizes seller and its agents,attorneys and employees to investigate the credit standing,financial circumstances and responsibility of buyer and all owners,partners,and/or officers listed on the reverse side hereof,and authorizes and instructs all persons having information concerning buyer's credit standing,financial circumstances and responsibility to release such information to seller,its agents,attorneys,or employees. This includes,without limitation,authorization for seller and its agents,attorneys and employees to request,obtain,and use for all purposes which seller deems necessary,a copy of any credit bureau or consumer credit report for the entities/persons listed herein at any time. The buyer further grants to seller a security interest in buyer's equipment,contract rights,inventories,receivables and proceeds of sales as collateral to secure the buyer's performance of all obligations. The buyer hereby appoints any employee,agent,or attorney of seller as buyer's attorney in fact to endorse and file on behalf of buyer any UCC I form to perfect or record the security interest. All of the information supplied by buyer is correct to the best of the knowledge of the undersigned,and the buyer understands that all goods and services purchased from seller arc subject to all terms and conditions contained in this credit application and agreement and all other terns and conditions on any of the seller's invoices. e q?- 7,�/SPo%r 401'7-'4 f CO/ ."5,- o°7 r ��r incpi"lf iki 7yiA' //_Z9-1/ By��r's Signature Q Title / Date Unconditional Guaranty In consideration of the extension of credit to ("debtor")by Tiffany Lawn&Garden Supply,Inc. ("creditor"),and for good and valuable consideration,the receipt of which is hereby acknowledged,the undersigned,jointly and severally,"if applicable",guarantee the full and prompt payment when due,whether by acceleration or otherwise,of all past,present and future indebtedness,obligations and liabilities of the debtor to the creditor, whether direct or indirect,joint or several,absolute or contingent,including all costs of collection,interest,and attorney's fees("obligations"). The undersigned waives acceptance of the Guaranty and further waives all notices and demands of any kind,including,but not limited to,all demands of payments and notices of nonpayment,presentment,protest and dishonor of any of the Obligations by the Debtor. The undersigned further waives all notices and,specifically,hereby consents to any extensions of credit,acceleration,modifications,immaterial alterations,material alterations,amendments or changes of terms of any agreements concerning the Obligations,including,but not limited to,any extensions or renewals of the Obligations or change of the rate of interest therefrom any notices,the acceptance of any partial payments or the release or transfer of any collateral for the payment of the Obligation. The undersigned also waives any claim,right,or remedy which such guarantor may now have or hereafter acquire against the debtor that arises hereunder and/or from the performance by the guarantor hereunder including,without limitation,any claim,remedy,or right of subrogation,reimbursement,exoneration, contribution,indemnification,or participation in any claim,right,or remedy of secured party against the debtor or any security which secured party now has or hereafter acquires,whether or not such claim,right or remedy arises in equity,under contract,by statute,under common law or otherwise. Guarantor and Co-Guarantor,if applicable,authorizes creditor to investigate Guarantor's and Co-Guarantor's personal credit standing,financial circumstances and responsibility and authorizes and instructs all persons having information concerning Guarantor's or Co-Guarantor's credit standing,financial circumstances and responsibility to release such information to creditor,its agents,attorneys or employees. This includes,without limitation,authorization for seller and its agents,attorneys and employees to request,obtain,and use for all purposes which creditor deems necessary,a copy of any credit bureau or consumer credit report for the Guarantor and Co-Guarantor at any time. This guaranty is a continuing guaranty of payment,and shall inure to the benefit of Creditor from the date hereon and shall remain in full force and effect until written notice of termination thereof has been received by Creditor by certified mail. Termination of the guaranty by the undersigned shall not effect any of the guarantor's obligations hereunder with respect to indebtedness incurred prior to the termination. No delay on the part of the Creditor in exercising any of the Creditor's options,powers or rights,or partial or single exercise thereof shall constitute a waiver thereof. All of the Creditor's rights are cumulative and alternative. Whenever possible,each provision of this guaranty shall be interpreted is such a manner as to be effective and valid under applicable law,but if any provision of this guaranty shall be prohibited by or invalid under applicable law,such provision shall be ineffective only to the extent of such prohibition without invalidating the remainder of the provision or the remaining portions of this guaranty. This guaranty shall inure to the benefit of the Creditor and its successors and assigns and shall be binding upon the successors and assigns,jurisdiction and preferred venue shall remain in , state of . In Witness Whereof,this document is executed on the day of ,20 - Guarantor(Personal Signature Only) Co-Guarantor (Personal Signature Only) Form ST-105 Indiana Department of Revenue State Form 49065 R4/8-05 General Sales Tax Exemption Certificate Indiana registered retail merchants and businesses located outside Indiana may use this certificate.The claimed exemption must be allowed by Indiana code. Exemption statutes of other states are not valid for purchases from Indiana vendors. This exemption certificate can not be issued for the purchase of Utilities, Vehicles, Watercraft, or Aircraft. Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence. Sales tax must be charged unless all information in each section is fully completed by the purchaser.Purchasers not able to provide all required information must pay the tax and may file a claim for refund(Form GA-110L)directly with the Department of Revenue. ,„ Name of Purchaser City of Carmel (Carmel Redevelopment Commission, an enterprise fund) • fia Business Address 30 West Main Street, Suite 220 City Carmel State IN Zip 46032 Ca Purchaser must provide minimum of one ID number below.* Provide your Indiana Registered Retail Merchant's Certificate 0031201550 — 020 TID and LOC Number as shown on your Certificate ico {fit TID#(10 digits) LOC#(3 digits) 14; If not registered with the Indiana DOR,provide your State Tax ;i ID Number from another State . *See instructions on the reverse side if you do not have either number. State ID# State of Issue Is this a blanket purchase exemption request or a 0 single purchase exemption request? (check one) =off .�i} Description of items to be purchased. x±'p Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain) ;14., ❑ Sales to a retailer,wholesaler,or manufacturer for resale only nt ❑ Sale of manufacturing machinery,tools,and equipment to be used directly in direct production. Sy,ri 0 Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin#10. g"'?°" (May not be used for personal hotel rooms and meals.) z,:pr '%i' ❑ Sales of tangible personal property predominately used(greater then 50 percent)in providing public transportation-provide USDOT#. mli A person or corporation who is hauling under someone else's motor carrier authority,or has a contract as a school bus operator,must o provide their SS#or FID#in lieu of a State ID#in Section#1. USDOT# f ❑ Sales to persons,occupationally engaged as farmers,to be used directly in production of agricultural products for sale. ' Note:A farmer not possessing a State Business License#may enter a HD#or a SS#in lieu of a State ID#in Section#1. 0: ❑ Sales to a contractor for exempt projects(such as public schools,government,or nonprofits). Sales to Indiana Governmental Units(agencies,cities,towns,municipalities,public schools,and state universities). z;r ❑ Sales to the United States Federal Government-show agency name. Note:A U.S.Government agency should enter its Federal Identification Number(111)#)in Section#1 in lieu of a State ID#. w ❑ Other-explain. I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt purpose pursuant to the State Gross Retail Sales Tax Act,Indiana Code 6-2.5,and the item purchased is not a utility,vehicle,watercraft,or aircraft. I confirm my understanding that misuse,(either negligent or intentional),and/or fraudulent use of this certificate may subject both me personally X04: and/or the business entity I � sent to e it position of tax,interest,and civil and/or criminal penalties. c1) %/- .29-7/ ` Signature of Purchaser Date Les Olds Redevelopmet Dir Printed Name Title The Indiana Department of Revenue may request verification of registration in another state if you are an out-of-state purchaser. Seller must keep this certificate on file to support exempt sales. OT U GWENT PLEASE RETURN THIS STUB WITH TELEPHONE (317)228-4900 YOUR REMITTANCE TO: FF�1�� n f (800)365-5678 . T1FF ANyGARDEN SUPPLY, INC. 4931 ROBISON RD. ✓ LAWN & INDIANAPOLIS, INDIANA 46268 GARDEN SUPPLY,,INC. ACCOUNT NO. 4931 ROBISON RD. • CITY OF C,.;RimEL—ADi+1INISTRAAA,TI0;u CT-I 754 CIqlIpFlIN6FOLLIgi;(wyt,NPAtegC3&,IISTF 1. CIVIC <_ Q L' RE STATEMENT DATE ACCOUNT NO. STATEMENT DATE (_'Ar.NT:1_ 5 IN 16032 10./01 /06 I:IT750 _10 /61 /08 c DATE REFERENCE CHARGES CREDITS BALANCE REFERENCE AMOUNT 'I 09 /30/01: 52.6327, €) MATT WORT 166 .00 166 .00 52632.`.' 166 .00 ACCUMULATED 0-30 DAYS 31-60 DAYS 61-90 DAYS OVER 90 DAYS FINANCE CHARGE BALANCE BALANCE A 166 . 0 ,0(.7L1 t;ic_ 00 . 00 1.66 . 00 DUE 1 f 6 .'1(.1 ANALYSIS OF BALANCE DUE NET 30 DAYS CHECK ITEMS BEING PAID-1 DISCOUNT AS MARKED;A SERVICE CHARGE WILL BE ADDED TO ALL PAST DUE-INVOICES. 'i Net 30 days from Date of Invoice C I FFAM/ $ 31 ROBISON RD INDIANAPOLIS,INDIANA 46268 317-228.4900•FAX 317-220-4910 Vitt.: • V.17;":1114;44I:vlizil III in.AIR LAwrq a 1-800.36S-5578 GARDEN SUPPLY,INC I.1)11:,: I :.1:1...,, 1 Q - ,1;7"itx/fzr--] 5:477 CNuU1 -7.7 s T- , •1- i;(-"iiTh11:11_ -i-iiit“ i i,i f•:17i ; PP i- i cii i H L ■ I- 1.1) f ' `..11..*!1. t..-11-•i'. I D P T Is.diim...1 Jo „..„0-.„: 0 HT FN i:-"i •TN; DREHI)0 f".. 0DIC TAX JURISDICTION NO./DESCRIPTION TAX EXEMPT* i -fl .5ri –&-ii--J vivivil INJJ.I.Hrlk I 1616.2,1 ;21/JI "D:-.:10-0.-2.16 LOC. DATE ORDERED DATE SHIPPED SHIP VIA JOB NO. PURCHASE ORDER NO. SALESPERSON CLK TERMS i !ZIT 14:1'.7.1/iil.1 /ILI--)16'.,:_./izi A :Cr e4 :5/li ifil9 ID ili:I NEI. 3IZI DA 0110.1 • ' * - ' E„.....,,,.-111, ... - '-',A-''''' ar,:,::".3,7:.ii u[9...4irils:qii,W-r:l'A- Lla..-~IIVLIVAAlitgilNI-WaNg.'Xi'.1014.,ODWfaii.:2it:N., ,;,,Pikt.....,... .'..,.....:;K: ......._. .._...,,,,,......,. ''.A.4-- Ii?A i n_-.:.. — - - - I.N V ui t...L. '— ' -I NO LH.1.117. • • •• ri,.1._=(..j i cE • - ..-.,. I DR–PLAN'rEI-4 ;I-00 -L. !DO PLAN TERs MI ..;:.-.;, Izirzi 11!Ili. izto ------------ — — -- • , I 4 I . ,4. I .. I .. 1 ', I , , —'.1,1 • IW011 SALES AMOUNT SALES TAX SHIPPING CHG. CODE DEPOSIT CASH CODE :i,::l. % I . . i / , t, 7/ I . , 25','.RESTOCK FEE / e......./----. \ -•• _.5' -,/,/-1:-"--7---,,k‘r_.-7, REC'D IN GOOD CONDITION//A / .,....v_....,-- ......-- .4.?,•-•"'—') 50%RESTOCK FEE ON SPECIAL ORDERS ' t' . —..--.— .....—. . . 7 --IFFANy 493i ROBISON no . Net 30 days from Date of Invoice INDIANAPOLIS.INDIANA 46288 317-220-4900•FAX 317.228-4010 iV",;.11r *•Y. LAWN& I-GOD-365-5670 q/30/0 GARDEN SUPPLY,INC. 4L 0 8 L l. I ,'' .!1.:1 3i 4'. I NV 0 1 C E ..,f g i..: 1 1 y or il.,i:i 14i ,:. II,, ! i I o! 1 ,s, CAREML REDEt.'LLOPNEHT L .1 L..i.YLC '.7i01.1(1HF.. p, CONNI f'.-.;S 1(11 . !:.5111.1 -1 .:10 \ -`-•\''..;' . . D 1 ./ 1 14k13-I. it Iii S r ,e,,' , ',,0 • -, LiLt.. j.I. L .Lj. .,. .10. C4, ILL , IN 46072 i' --- ,i .,.. , ATTN (1111-it. N4 Fr wr.n f TAX JURISDICTION NO./DESCRIPTION TAX EXEMPT' - I.:::17', 57 I--..:7_:-:i t.,!-.5 v..IWIDI 1HUIIAN(71 inX 0031LmIttrO-020 LOC. DATE ORDERED DATE SHIPPED SHIP VIA JOB NO. PURCHASE ORDER NO. SALESPERSON ELK TERMS COPY 010g/Rff!/08091218 MATT WORT. 0 10 NET 30 DA C110 PF-44litit:LN4,2•_4wwff:=E-0--`r '.,AZtviftf 'AM4Mffikg,{v.f.4tNIMIVNN-rEZZXPZMEEigrtVfKN'il Itmtri I LE: • • I ki ,'Ll 1 EL INVOICE INVOICE 1 I NAIL ----111 .1.4ES1 MAIN ST- -SUIT-140 CARMEL IN 412132, THEY I.4ILL BE PAYING THIS DILI_ _ . . .. PO-- -----162.4 9---HIATT 140 RI111._Esr SHERRY NIELKE-, ----571-278..',-)TOFF.tgE. EL b 8, 1.?.1121 I 'III BROWN FIELD SOIL 20„ 7 'r, lr-,60 01 :;IJ'i I) FOR PICK 1JF:1T- • • - \.) 1 !:"..c.,,, Pv.'t 4-) .16E, 'ilifi SALES AMOUNT SALES TAX SHIPPING CHO. CODE DEPOSIT CASH 0740%.10WPOT.' ___ . . _......_„. .....,-- . , 50 ,RESTOCk ORDERS RESTOCK FEE RECD IN GOOD CONDI . °,'. FE,E,ON SPECIAL i . CUSTOMER INVOICE