Company Name:
EIN:
Address
City/State/Zip Code:
Country:
Phone # (Area Code):
Fax # (Area Code):
E-Mail Address:	Required Incorrct Fromat
References: (Give Company Name, Address, Phone, Account # and contact name for each.)
Trade Reference 1:
Company:
Address
City, State, Zip
Contact
Telephone
Trade Reference 2:
Company:
Address
City, State, Zip
Contact
Telephone
Trade Reference 3:
Company:
Address
City, State, Zip
Contact
Telephone
Bank Reference:
Name:
Address:
City, State, Zip:
Contact:
Telephone:
Account #:
Persons authorized to make purchases:
Name 1:
Name 2:
Name 3:

The undersigned (the "Company") hereby applies for a business credit account with Digicomm. The credit is not for personal, household or family use. The Company will abide by the terms as charged or as set out on any contract, purchase order, invoice, bill of lading or any other documents, all of which are made a part hereof, for any goods, equipment and service delivered by Digicomm at the cost of goods, equipment or services and payment will be due according to mutually agreed terms. By this document (The "Agreement") Digicomm is entitled to obtain credit information from the references listed above.

In all goods and equipment purchased under the account created by this application as described in the shipping invoice, the Company grants to Digicomm a security interest to secure performance and payment of its obligations.

The Signatory here to warrants that he or she and the person(s) listed above have the authority to obligate the Company by purchased goods, equipment and services from Digicomm, and that he or she has the authority to bind the Company to this Agreement. The Company shall be responsible for payment of all sales and use taxes and shall indemnify and hold harmless Digicomm from any loss, cost, or expense Digicomm may incur, including attorney fees and court costs, in the event the Company fails to pay such taxes.

The Signatory warrants that he or she has personal knowledge of the financial condition of the company and represents that the Company is in good financial condition, will be able to pay Digicomm in the amount of the credit limit, and will so pay within mutually agreed terms. In the event of a breach of this agreement, then Digicomm shall be entered to all costs of collection, including reasonable attorney's fees. In the event of failure of timely payment Digicomm shall be entitled to receive interest on the past due amount at the annual rate of eighteen percent (18) in addition to the principal balance.

The place of performance and transaction of business shall be deemed to be in the County of Arapahoe, State of Colorado, and in the event of litigation, the obligor consents to in personam jurisdiction of the Colorado courts, County of Arapahoe, State of Colorado.

Should any of the provisions of this Agreement be deemed by a court of competent jurisdiction to be void, voidable, or unenforceable, only that provision shall be affected thereby and all other provisions shall remain enforceable.