CREDIT APPLICATION

STEP 1/3

APPLICATION FOR CREDIT

Firm Name

Date

Business Address (Not P.O BOX)

Address

City:

State:

Zip:

Tract:

Lot:

Phase #

E-mail Address

Mailing Address

Project Start Date:

Expected Completion Date:

SOLE PROPRIETORSHIP AND PARTNERSHIPS:

Name

Res. Phone

Residence Address

Email Address

Calif. Drivers License No.

Name

Res. Phone

Residence Address

Email Address

Calif. Drivers License No.

Corporations

Date Incorporated

State

President

Residence Address

Secretary

Res. Phone

Residence Address

Email Address

General Information

State Contractors License #

Type

License Name

Email Address

Are your sales TAXABLE

or RESALE

Resale #

Where do you bank?

Branch

Address

State

Zip

Account Numbers

REFERENCES: (GIVE ONLY NAMES OF THOSE YOU BUY FROM AN OPEN ACCOUNT)

Name

Phone

Name

Phone

Name

Phone

Name

Phone

Real Estate Owned

Value $

Mortgage $

Machinery & Equipment

Value $

Mortgage $

STEP 2/3

WORK HISTORY EDUCATION

Applicant understands and agrees that all invoices are due and payable on the 10th of the month following the month in whuch invoices are dated and that past due accounts will bear interest at the rate of one percent (1%) per month; in addition, because the damages resulting from nonpayment of the accounts are difficult to ascertail, applicant agrees to pay a late charge of one-half percent (.5%) per month on past due accounts. The finance charges shown on the account statements will include the interest charges and late charges.

In the event it becomes necessary to file suit to enforce payment, such suit may be brought in Riverside Country or San Diego Country, California at sellers option, and Superior Ready Mix Concrete will be entitled to recover all collections costs, attorney's fees and interest/late charges on all amounts found to be due and payable. All transactions are deemed made, payable, and due at Superior Ready Mix Concrete's principal place of business at Escondido, California.

In order for the transportation charges on the delivery or aggregate materials to be non-taxable item for sales tax purposes, we agree that title to all aggregate materials purchased by the undersigned from Superior Ready Mix Concrete L.P, passes to the customer at the time of loading into trucks at any of the plants of Superior Ready Mix Concrete L.P. This agreement will be effective whether the transportation is by independent carrier, the undersigned's trucks, or by trucks owned by Superior Ready Mix Concrete L.P

Calls to dispatch and customer service may be recorded for quality assurance purposes.

The applicant consents to receiving faxes at the fax number listed above and any replacement fax number for the applicant, and agrees to submit complete "job information" on or before the first delivery or concrete or material to each job of customer.

By entering my name in the signature block below, I agree to the above terms.

Signed

Date

Title

PERSONAL GUARANTY BY CORPORATION STOCKHOLDERS

I/We personally guaranty payment of any and all indebtedness of the corporate account and agree to be bound by the terms and conditions noted on the application, It shall not be necessary for Superior Ready Mix to first exhaust its remedies against the corporation or any other security. We each acknowledge that as to ourselves that the guaranty shall continue in full force and effect not withstanding the death or release by operation of law any other guarantor(s). We each expressly waive notice of nonpayment by the corporation and waive diligence on the part of Superior Ready Mix in collection of the indebtedness.

By entering my name in the signature block below, I agree to the above terms.

Signed

Name

Date

Residence Address

Phone

Social Security No.

Calif. Drivers License No.

Signed

Name

Date

Residence Address

Phone

STEP 3/3

AFFIRMATIVE ACTION SURVEY STATEMENT / PERSONAL INFORMATION / GENDER & ETHNIC GROUP / RACE

CUSTOMER RELEASE AUTHORIZATION FORM

Signed

Name

Date

Residence Address

Phone

Social Security No.

Calif. Drivers License No.

Signed

Name

Date

Residence Address

Phone

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