• **Entire Form must be completed to establish a pre-pay account**
  • MM slash DD slash YYYY
  • Billing Information

    *If exempt, must provide an exemption certificate
  • Location that the order is being received and/or work being performed:

  • Agreement:

    The above information is for purpose of establishing an account with Stafford-Smith, Inc. and will be held in the strictest confidence. I (we) agree to the terms set forth by Stafford-Smith, Inc. in regard to billing and payment of invoices for equipment received, stored on my/our behalf or services rendered. Invoices not paid according to those terms are subject to a time price differential of 1.5 % monthly. If any sums shall not be paid when due under this agreement, Stafford-Smith, Inc. may, at its option, declare all sums owing immediately due and may refer the account to its attorneys for collection. It is agreed that any litigation arising out of an unpaid balance shall be in the state of Michigan, County of Kalamazoo, whose law shall apply. I (we) agree to pay reasonable attorney’s fees together with the unpaid balance and court costs. Stafford-Smith, Inc. reserves the right to change the terms of this agreement at its discretion. I (we) authorize Stafford-Smith, Inc. to file a financing statement and/or fixture filing describing the collateral. Warranties are conditioned on your paying the full purchase price for the equipment.

    Guarantee for Corporation: For valuable consideration, I (we) personally guarantee full payment of all invoices on this account and submit to the jurisdiction and law and courts in the State of Michigan. No extension, indulgence, or oral release shall prevent my (our) remaining fully liable. I (we) waive notice of default.

  • The parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility. You may opt out of signing this agreement electronically by printing this agreement, signing it, and mailing the original to Stafford Smith, Inc. at 3414 S. Burdick St., Kalamazoo, Michigan 49001.

  • This field is for validation purposes and should be left unchanged.