Customer Application Form

We certify that all the information on this form is true and correct and agree to pay for all goods purchased in compliance with the terms of the seller. We fully understand that unless otherwise agreed to in writing, your credit terms are net 30 and agree to pay in full within those terms. In consideration of any goods, materials, and service of labor provided to applicant on an open account or otherwise by Rolls Scaffold, Inc., the undersigned personally will guarantee Rolls Scaffold, Inc. the extent of, and not exceeding at any one time, the amount due, together with interest thereon and cost of collection thereof, including reasonable attorney fees, court costs and returned check charges.