Credit Application and Policies

             The Lab Safety Institute accepts purchase orders from organizations that have completed this credit application and accepted the terms of payment.  

Organization: ____________________________________________

Address:  _______________________________________________ 

City: ___________________________  State: _____  Zip: ________

For: ___________________________________________________ 

Person Responsible for Preparing Payment:

Name: _______________________________________________________

Phone: ( ___ ) ___ - _______   Fax: ( ___ ) ___ - ________

Email: __________________________________________________

Terms of Payment:

1.         An invoice will be faxed to the person responsible for preparing payment and a confirmation copy will be mailed.  Payment is due upon receipt of the faxed invoice.

2.         If full payment is not received within two weeks, a late fee of $25.00 will be applied to the account and an updated invoice will be faxed to the person responsible for preparing payment.

3.         Payments not received within one month will be assessed a monthly interest charge of 1.5% of the outstanding balance.  An updated invoice will be faxed to the person responsible for preparing payment.

We accept the terms of payment and agree to make full payment of invoiced charges and all late fees and interest charges as described above.

__________________________________      _________________

                        Authorized Signature                                           Date                  

Please fax the completed form to 508-647-0062