Credit Application & Agreement

Please complete our secure credit application/agreement form below and our accounting department will begin processing your application within 24-28 hours if submitted on a weekday. Once your references are checked and it’s determined that your company has met our requirements we will set up your account with payment terms of NET 30.

You/your company will be considered a COD customer until your account is formally established. Until then, our dispatch/accounting office will need to have a valid credit card on file before a crane can be sent out. We take American Express, MasterCard and Visa as forms of payment. Any prior COD work completed and unpaid for must be fully paid off before a NET 30 account can be opened.

Be advised that Phoenix Crane Rental does not have access to Dun and Bradstreet to review your company’s credit worthiness so the references you provide and most importantly their contact information (email addresses and/or fax numbers) are vital for us in processing your application.

Your information is encrypted and sent directly to our in-house A/R Specialist via an SSL certificate, ensuring that any data transmitted remains private and secure. Submitted forms are then deleted from our server. Should there be an issue setting up your NET 30 account (either with incorrect information or inadequate references), you will be required to resubmit this form.

CLICK HERE TO DOWNLOAD A PDF OF OUR CREDIT APPLICATION

You may return completed applications to:

Phoenix Crane Rental
1855 Dickerson Drive
Mableton, GA 30126

or scan and email them to:

anichols@phoenixcrane.com

Company Information
Full Legal Business Name:*
Doing Business As (or Also Known As):
Leave Blank if N/A
Business Address (No P.O. Boxes):*
Street Address Address Line 2 City State ZIP Code
Primary Billing Contact:*
First Last
Business Phone*
Business Fax
Email*
Nature of Your Business/Industry:*
Purchase Order (PO) Required?*
- Yes
- No
Business Credit Information
Tax Payer ID #:*
In Business Since:*
Number of Employees:*
Annual Revenue:*
Legal Structure:*
- Corporation
- Partnership
- Sole Proprietorship
- LLC
Officer's Name:*
First Last
Phone Number:*
Officer's Name:
First Last
Phone Number:
Trade References:
Company 1 Name:*
Company 1 Phone:*
Company 1 Fax:*
Company 1 Account #:*
Company 2 Name:*
Company 2 Phone:*
Company 2 Fax:*
Company 2 Account #:*
Company 3 Name:*
Company 3 Phone:*
Company 3 Fax:*
Company 3 Account #:*
Bank Reference:
Bank Name:*
Checking Account #:*
Bank Phone:*
Authorization:
I/We certify that all information is true and complete. This request is for a Phoenix Crane Rental Company charge account. I/We authorize Phoenix Crane Rental Company to obtain further information concerning credit and financial condition of the corporation, principal owners, proprietors or partners and to exchange or provide information with other credit grantors. I/We agree to pay the amount invoiced in full and will provide Phoenix Crane Rental Company a separate financial statement upon request. In the event Phoenix Crane Rental Company extends credit to the applicant, the applicant agrees that Phoenix Crane Rental Company may assess interest and service charges on purchaser’s outstanding account balance at a rate of 1.5% per month (18% annum). Phoenix Crane Rental Company’s payment terms are Net 30 on all accounts. The purchaser further agrees to pay all costs of collection, including 15% attorney’s fee, in the event applicants account is turned over to any attorney. It is agreed that this agreement will be governed under the law of the State of Georgia. Phoenix has the option of pursuing an action under this agreement in any court of competent jurisdiction in the State of Georgia. It is agreed that seller shall retain the title to any goods sold until payment in full has been received by seller.
Electronic Signature:*
Please type your full first and last name.
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Name
This field is for validation purposes and should be left unchanged.

24/7 Dispatch & Emergency:

1855 Dickerson Drive

Email Address:

Credit Application & Agreement

Credit Application & Agreement

Company Information

Business Credit Information

Trade References:

Bank Reference:

Authorization: