Is Purchase Order Number Required?
If yes, please provide PO# with sample submittal .
Credit Card Information (if authorizing charges)
Name on Card:
Please provide Credit Card information with sample submittal – not accepted 30 days after invoice date.
All new clients, without established accounts, are required to submit payment in full with first set of samples.
Payment terms are net thirty (30) days with 1.5% assessed monthly to overdue accounts.
Other payment terms require written pre-approval from EnviroChem’s Accounts Receivable Department.
All discounts/contract pricing is predicated on receipt of payment within thirty (30) days of date of invoice.
In the event that collection becomes necessary, client agrees to pay the reasonable costs of collection including reasonable attorney’s fees and interest.
Client Accounts Payable Representative
I approve of Net 30 day payment terms
Digital Signature (By selecting this box you are digitally signing this online form)
Client Project Contact
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