Detroit Certified Public Truck Scale

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This contract is between Courtesy Transfer Inc and

There will be a $10.00 charge for each time your truck goes across the scale located at 13552 Sanders Detroit Mi, 48217.

Firm's Full Legal Name:

Phone Number:

Fax Number:

Billing Address:

Street Address:

Please Select One: —Please choose an option—ProprietorshipPartnershipCorporation

State Incorporated in:

Trade References (Please include name, address, city, state, and zip):

Please list the companies that will be using the scales and will be billed to your company. (Please put each company on a separate line.)

I/we understand that the terms of the billing are net 30 days from the date of the billing invoice. Courtesy Transfer Inc may charge interest on any past due balance at the rate of 15% for balances over $350.00 or $5.00 for balances up to $350.00. I/we hear by agree jointly and individually to pay for all services rendered supplied to us by the above business. In the event that the account is placed with a third party for collection, I/we agree to pay all costs including reasonable attorney fees, court cost and finance charges. I/we authorize Courtesy Transfer Inc to investigate our credit history, bank references,and any information deemed necessary to extend credit. I/we agree to immediately notify Courtesy Transfer Inc in writing of any changes in ownership, form of business, address, or termination of person authority to incur our charges under the account on behalf of the applicant.

Signature of Acceptance:

Date of Signature:

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