CONFIDENTIAL CUSTOMER CREDIT APPLICATION Please return completed application Email: applyforcredit@dmtholdings.com. Mail to: General International Power Products LLC. 33400 9th Ave. South STE 209. Federal way, WA 98003 Business Name Trade Name/Doing Business as (DBA) Physical Street Address City State Zip Billing Address City State Zip Contact Name Telephone Number Facsimile Number Business Established Month/Year Federal Tax Identification Number Type of Business (Circle One)ProprietorshipPartnershipCorporationOther: Other Principal Owner(S) Is Your Company Listed With Dun & Bradstreet? Duns# E-Mail Address Bank Reference Information: Bank Name Bank Address Bank Officer Telephone Number Facsimile Number Checking Account Number Savings Account Number Loan Number The undersigned has requested General International Power Products LLC to extend credit to the said company listed above on a continuing basis. In order to enable General International Power Products LLC. to make a credit investigation, authorization is hereby given to you to disclose and discuss with General International Power Products LLC. all information and documents you may have concerning the credit history and credit status of the undersigned. THE ABOVE INFORMATION IS FOR THE PURPOSE OF OBTAINING CREDIT AND IS WARRANTED TO BE TRUE. I/WE HEREBY AUTHORIZE General International Power Products LLC TO INVESTIGATE THE REFERENCES LISTED PERTAINING TO MY/OUR CREDIT AND FINANCIAL RESPONSIBILITY. AGREEMENT BY SIGNING BELOW, IF A LINE OF CREDIT IS GRANTED, WE (BUYING COMPANY) WILL ABIDE BY THE CREDIT TERMS EXTENDED BY SELLER (General International Power Products LLC) BUYING COMPANY AGREES WITH SELLER TO REMIT PAYMENT FOR INVOICES (ORDERS) SHIPPED WITHIN 30 DAYS. INVOICES NOT PAID BY THE 31ST DAY WILL BE CONSIDERED DELINQUENT. WE UNDERSTAND THAT General International Power Products LLC. RESERVES THE RIGHT TO CHARGE OUR ACCOUNT INTEREST AT THE RATE OF 1.5% MONTHLY (18% ANNUALLY) ON INVOICES NOT PAID BY THE DATE STATED ON THE INVOICE. IF IT SHOULD BECOME NECESSARY TO USE A COLLECTION AGENCY OR COURT OF LAW TO COLLECT AMOUNTS DUE, WE AGREE TO PAY ALL REASONABLE COLLECTION EXPENSES. THE TERMS AND CONDITIONS, THEIR VALIDITY, INTERPRETATION AND ALL CLAIMS OR CONTROVERSIES BETWEEN General International Power Products LLC. AND THE BUYING COMPANY ARISING HERE UNDER SHALL BE GOVERNED AND CONSTRUED UNDER THE LAWS OF Ohio. BUYING COMPANY ASSUMES FULL RESPONSIBILITY FOR ALL MATERIALS PURCHASED FROM SELLER. BUYING COMPANY AGREES TO BE LIABLE FOR ALL CHARGES AND GUARANTEES PAYMENT OF ALL CHARGES PROMPTLY. BUYING COMPANY AGREES TO NOTIFY SELLER WITHIN FIVE DAYS OF RECEIPT OF PRODUCT IN WRITING OF ANY BILLING DISCREPANCIES. FAILURE TO NOTIFY SELLER SIGNIFIES TOTAL ACCEPTANCE AND RESPONSIBILITY FOR PROMPT PAYMENT IN FULL OF ACCOUNT. ALL SALES ARE FOB Whitehouse, OH unless otherwise stated on formal quotation from General International Power Products LLC. BUYING COMPANY AGREES THAT REFUNDS/CREDITS FOR MERCHANDISE PURCHASED ARE GRANTED ONLY ACCORDING TO General International LLC RETURNS/REFUNDS/WARRANTY POLICIES. SIGNATURE REQUIRED Customer Authorized Signature Title Date General International Power Products llc Authorized Signature Title Date Anticipated Largest Purchase $ Terms Most Recent Interim Statement Anticipated Annual Purchase $ Credit Limit $ Send to: General International Power Products LLC 6243 Industrial Parkway Whitehouse OH 43571 Att: Accounting Credit Dept DMT Holdings Authorized Signature DATE Trade Reference Information Business Name Contact Name Telephone Number Facsinile Number Steet Address City State Zip Business Name Contact Name Telephone Number Facsinile Number Steet Address City State Zip Business Name Contact Name Telephone Number Facsinile Number Steet Address City State Zip Business Name Contact Name Telephone Number Facsinile Number Steet Address City State Zip Business Name Contact Name Telephone Number Facsinile Number Steet Address City State Zip SALES TAX RESALE/EXEMPTION INFORMATION PLEASE PROVIDE SALES TAX RESALE/EXEMPTION FORMS FOR ALL STATES YOU WILL BE SHIPPING TO. WE ARE OBLIGATED BY LAW TO BILL AND COLLECT EACH STATE'S SALES TAX IF THESE FORMS ARE NOT ON FILE. I certify that Name of firm (Buyer): Steet Address City State Zip is a registered (circle one):WholesalerRetailerManufacturerOther Other(specify) State Registration Alabama Arizona Arkansas California Colorado Connecticut Florida Georgia Hawaii Idaho Illinois Indiana Iowa State Registration Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Nebraska Nevada New Jersey New York State Registration North Carolina Ohio Oklahoma Pennsylvania South Carolina Tennessee Texas Utah Virginia Washington West Virginia Wisconsin Other(list state) I further certify that if any property so purchased tax free is used or consumed by the firms as to make it subject to a sales or use tax, we will pay the tax due direct to the proper taxing authority when state law so provides or informs the seller for adding tax billing. This certificate shall be part of each order which we hereafter give to you, unless otherwise specified and shall be valid until cancelled by us in writing or revoked by the city or state. General description of products to be purchased from the seller: Under penalties of false statement that this certificate has been examined by me and to the best of my knowledge and belief is a true, correct, and complete certificate. CUSTOMER Authorized Signature Signature Title Date Complete and Return this Application to: Email: applyforcredit@dmtholdings.com Mail: 33400 9th Ave S Ste 209 Federal Way, WA 98003
