QVS - Reseller Credit Application
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 UPDATED: 12/20/13
 
RESELLER CREDIT APPLICATION

I/WE herein make application to QVS for credit and/or to update and reconfirm our existing account and balance with QVS Applicants give their permission to QVS to verify the information stated herein. If credit is granted, I/WE promise to pay all bills rendered within the terms set forth by the QVS Credit Department. Please complete this form or download the Reseller Credit Application in PDF format and fax or mail to QVS.

Company Information
Company Name: *

Business Name:

State Resale #:

Contact Name:*

Email Address:*

Daytime Telephone:*

Fax #:

Address:

City:

State/Province:

Postal Code:

Country:


Company Owned Real Property:
No Yes
Complete Addres: (If different from above)
Business Classification:

How Long in Business?(yrs)

Federal ID #:*

D&B#:

Type of Business:

Incorporated in What State?

If less than one year, previous address:


Bank Reference
Company Bank:

Account#:

Bank Branch:

Contact Person:

Address:

City/State:

Phone#:

 

Trade References

Supplier Name:

Phone #:

Fax:

Contact Name:

Address:

City/State/Zip:

 

Supplier Name:

Phone #:

Fax:

Contact Name:

Address:

City/State/Zip:

 

Supplier Name:

Phone #:

Fax:

Contact Name:

Address:

City/State/Zip:

 

Authorized People to Purchase:

Purchase Order(s) Required:
No Yes

Request Credit Desired:

Estimated Monthly Purchases:

 

Principals of Company
Name:

Social Security #:

Title:

Address:

Own Rent

 
Name:

Social Security #:

 Title:

Address:

Own Rent

 

Brief Survey

How did you hear about us?
Other:

Product Interest:
Category 5 & 6 Cisco Cables Displays/Video DataLine Surges
DataSwitches Digital Signage Fiber Optics Fibre Channel
Firewire Internal PC Cables KVM Switches Apple Cable & Accessories
Multimedia A/V Parallel Peripheral Sharing PC Accessories & Toolkits
Power Protection SCSI Serial USB 2.0/3.0
Other:

 

Default Agreement - Corporation

In the event payment is not made and this account is referred for collection, I/WE will pay the cost of collection equal to a minimum amount of twenty-five percent of the principal amount except limited by local law. I/WE understand interest on any unpaid balance will be charged at the highest rate authorized by law. If suit or action by an attorney is instituted, I/WE promise to pay reasonable attorney fees in said suit or action. It is understood that all billing of accounts receivables & credit are processed through head-quarters in Wayne County, MI. It is understood that in the event of a suit or action, it is understood that Wayne County, MI, at the option of QVS is the venue for litigation. I/WE understand that I/WE are waiving our right to litigate outside of Wayne County, MI.

Initials: Date:

 

Proprietor/Owner

I/WE undersigned agree to guarantee payment of all sums due and owing. I/WE understand that venue is as stated above and this continuing guarantee shall not be revoked except by 90 days advance written notice to QVS.

Initials: Date:

 

If you are currently working with a QVS Account Manager, please specify on the space below.

Sales Representative:

** Note: As a QVS reseller, you will receive product news and promotions either by mail, fax, and/or email. Qvs does not sell, trade, or rent any information you have provided to us.

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