Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company InformaionStreet Address *City/State/Zip *FirstMiddleLastContact Name *Contact Phone Number *Contact Email *Accounts Payable *Account Payable Phone * Payable To: Number Accounts Payable Email *Type of Business *Tax ID / Social Security Number *Years in Business *Email my New Client Account Number To: *Terms of use: *Same Day Express liability for loss or damage, for any reason, to all shipments shall in no event exceed $100. It is acknowledged by signature that all invoices are due thirty (30) days following date of invoice, unless stated differently on the invoice,. If invoices not paid within the 30 days, the 10% discount will no longer be available on all orders. If terms have not been met after sixty (60) days, the account is subject to cash only basis. In the event of defaulter litigation for lack of payment, the undersigned agrees to pay all collection fees, interest charge 3% per month (36% per annual) and / or attorney's fees, whether or not suit is filed. Applicant's signature represents financial responsibility, ability and willingness to pay our invoice in accordance with the above terms. ((Check box that you have read and agree to the Terms and Conditions of Same Day Express Delivery Services, Inc.))How did you hear about us: WebReferralSame Day Express RepresentativeOtherSubmit