Vandalia Rental Credit Application

The information Provided is Strictly Confidential and Secure.

This application is for the purpose of establishing a line of credit with Vandalia Rental. Please complete all information. Your digital signature is acceptance of all terms and conditions as noted.

For any questions, please contact us at creditapp@vandaliarental.com.

Step 1 of 7

Business Information

Account Name (Individual or Company)(Required)

Address(Required)

Street Address City State ZIP Code

County(Required)

Billing Address (Required)

Same as Business

Billing Address(Required)

Street Address City State ZIP Code

County(Required)

Business Phone(Required)

Fax#

Identification Number

Federal ID #

SSN

Federal ID #

Social Security Number

Industry(Required)

Number of Employees(Required)

Please enter a number greater than or equal to 1.

Est. Monthly Rent Volume

Years in Business(Required)

Type of Business

Sole Prop

Partner

LLC

Corp

Government

Not for Profit

Banking Information
Bank Name(Required)
City & State(Required)
City State

Contact
Phone
Account #

Account Preferences
Please let us know your preferred location, if known:
If a representative has been helping you, please tell us who:
Who has been helping you?
Do you require a purchase order or job name on each invoice? If yes, equipment will not be released unless provided.(Required)

Yes

No
Are you tax exempt?(Required)

Yes

No
Select any(Required)

All rentals/purchases

Job Specific (per job)
Tax Exemption Form Will Be Required
If all rentals/purchases are tax exempt, please provide your blanket tax exemption certificate.
Tax Exemption Forms Will Be Required
If tax exemption is job specific, a tax exemption certificate will need to be provided prior to that rental.
Do you have any restrictions on who can order and sign for equipment?(Required)

Yes

No
List all authorized personnel
Name(Required)
Mobile #(Required)
Email

Name
Mobile #
Email

Name
Mobile #
Email

Name
Mobile #
Email

Additional authorized users may be listed on a separate sheet with their contact information
PLEASE READ CAREFULLY

Rentgard: Rentgard is a damage waiver that covers the initial $5,000 of accidental damage to a piece of equipment. Rentgard is NOT INSURANCE and does not provide any benefits for personal or property injury or protection against liability to employees, agents of the Lessee or third-parties. Rentgard does not cover theft, loss of accessories, or costs due to customer negligence, in accordance with terms printed on the front and reverse side of each rental contract. In the event you elect to decline Rentgard, you may be responsible for the full cost of all repairs up to the full replacement value of the equipment. The price of Rentgard is 15.5% of the rental cost of equipment.
Do you wish to purchase Rent-Gard Protection on each contract?
Yes
No
Certificate of Insurance Required

A certificate is required for general liability and property coverage equal to or above the replacement value of equipment rented. Vandalia Rental, PO Box 160, Vandalia, OH 45377 must be listed as additional insured and loss payee for rented/ leased equipment as well as the certificate holder. The general liability and property coverage limits (dollar amounts) for rented/leased equipment must be listed. (See COI example below.)
Insurance Company Name
Agent Name
Phone
Email

Failure to supply a valid COI will automatically default all contracts to be charged Rent-Gard until one is received.
Download COI Example
Download COI Example

For more information, please contact our Credit Department at 937-454-7427

COI Agreement(Required)
I have read the above and will be providing a COI

BND Rentals, Inc DBA Vandalia Rental Credit Agreement

The undersigned(s) grant Vandalia Rental permission to investigate/verify credit information.

The undersigned(s) grant Vandalia Rental permission to report to proper agencies and/or credit bureaus the performance of this agreement.

The undersigned(s) acknowledge the terms of this Agreement. Any amount past due will be assessed a 2% Service Charge per month (Annual Rate 24%). Net 30 days from billing date of invoice.

By executing this Credit Application/Contract, the undersigned(s) jointly and severally if more than one (1), agrees to comply with all provisions thereof and to pay all sums and charges on this or any account opened and/or maintained in my name, including purchase costs of materials, and service charges, whether incurred by me or by my agents.

This Agreement, and any amendment thereto, is subject to credit approval. Any amendments to, or deviations from, this Agreement must be in writing. This Agreement supersedes all prior agreements, unless otherwise stated, and governs all purchases made to date and after the above date.

Each person signing this Agreement (with the exception of Seller) is a Buyer, and the obligations hereunder of all Buyers are joint and several. This Agreement benefits Seller, its successors and assigns, and binds the Buyer(s) and their respective heirs, personal representatives, successors and assigns.

If customer issues purchase orders or other documents relating to any purchases, and any terms thereof conflict with the terms herein, the terms and conditions of this Agreement shall govern.

Delivery of equipment to the construction site constitutes delivery to customer, regardless of whether customer or his agent is at the site at the time of delivery. Vandalia Rental shall not be responsible for failure or delay in delivery. Customer waives any claims for damages arising by virtue of delay in delivery of equipment by Vandalia Rental., regardless of the cause of the delay.

In the event a construction lien is filed against a project, all discounts are subject to revocation at discretion of Vandalia Rental. All discounts are applicable so long as customer's account(s) with respect to any purchases is not in default.

All claims for shortages or improper delivery must be made in writing within five (5) days of delivery or they will be disallowed. Any claims for adjustment or corrections of billing, must be made within five (5) days of receipt of invoice.

The Undersigned(s) Personally Guarantee(s) the Performance of this Credit Agreement
I understand and agree that my application will be signed electronically, which is the legal equivalent of my handwritten signature. I also understand that my electronic signature means that I or my company intends to apply for a credit account with Vandalia Rental using the personal information supplied below.(Required)
I Agree
I understand and agree that my application will be signed electronically, which is the legal equivalent of my handwritten signature. I also understand that my electronic signature means that I or my company intends to apply for a credit account with Vandalia Rental using the personal information supplied below.
I Agree
Print Name(Required)
Title(Required)
Print Name
Title
Guarantor's Birth Date(Required)
MM slash DD slash YYYY

Guarantor's Social Security Number(Required)
Guarantor's Birth Date
MM slash DD slash YYYY

Guarantor's Social Security Number
Guarantor's Address(Required)
Street Address City State ZIP Code

Guarantor's Address
Street Address City State ZIP Code

Guarantor's Email(Required)

Guarantor's Email

Driver’s License Number(Required)
Driver’s License Number
Acknowledgment of Applicant
I understand and agree that my application will be signed electronically, which is the legal equivalent of my handwritten signature. I also understand that my electronic signature means that I am acting on behalf of the business or individual intending to apply for a credit account with Vandalia Rental using the information supplied and agree to the terms of credit. I declare under penalty of perjury that I have examined all the information on this application and it is true and correct to the best of my knowledge(Required)
I Agree
Date(Required)
MM slash DD slash YYYY

Print Name(Required)
Title(Required)
Applicant's Email(Required)

Download COI Example
Upload Document(s)-Examples: COI, Tax Exemption Certification, or Other Pertinent Documents

Drop files here or

Accepted file types: pdf, jpg, png, docx, doc, xlsx, xls, Max. file size: 30 MB, Max. files: 3.

Provide Any Additional Notes That May Be Helpful
Additional and future information may be sent to creditapplication@vandaliarental.com
Upon submission, a copy of the supplied information will be available for download.

Vandalia Rental Credit Application

The information Provided is Strictly Confidential and Secure.

Business Information

Billing Address (Required)

Officers Information

Accounts Payable

ACH/EFT Payments

Checks

Phone Credit Card Payments

Banking Information

Account Preferences

Tax Exemption Form Will Be Required

Tax Exemption Forms Will Be Required

PLEASE READ CAREFULLY

Certificate of Insurance Required

Failure to supply a valid COI will automatically default all contracts to be charged Rent-Gard until one is received.

Download COI Example

For more information, please contact our Credit Department at 937-454-7427

BND Rentals, Inc DBA Vandalia Rental Credit Agreement

The Undersigned(s) Personally Guarantee(s) the Performance of this Credit Agreement

Acknowledgment of Applicant

Additional and future information may be sent to creditapplication@vandaliarental.com

Upon submission, a copy of the supplied information will be available for download.

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