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Payment Terms (Net 30 days standard)
Complete all fields and provide at least one owner, partner or officer.
Please provide information of at least three trade references.
This application is submitted for the purpose of obtaining credit with Medisa and is warranted to be true. By signing this application the undersigned acknowledges that he/she is authorized to execute this application and to obligate the company to make payment in full for all amounts due according to invoice on or before the net due date. Additionally, the undersigned will be responsible for all collection costs and attorney fees, with or without lawsuit, in order to collect any delinquent moneys.
The undersigned hereby authorizes Medisa Pty Ltd, to make such inquiries (corporate/personal) as are necessary to obtain credit information and authorizes the bank(s) of record to release information regarding accounts.
I/We accept the terms and conditions as set out within the Credit Application for MEDISA Pty Ltd.
Please sign below before submitting.
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