Application for Credit
PO Box 585 (2201 Moon Street), Tucker GA 30085
Corporate Office: 770.938.4208 Corporate Fax: 770.491.3198
Tucker Phone: 770.938.4200 Cumming Phone: 770.889.6092
Canton Phone: 770.479.6571 Dahlonega Phone: 706.867.0900
Grayson Phone: 770.466.4170 Auburn Phone: 770.822.9611
Covington Phone: 770.788.0404 Gainsville Phone: 770.718.1232

A PDF version of this credit application can be downloaded here.

Salesman
1-800-CONCRETE
*Date
*Name (Company/Individual)
*Street Address
*City
*State:
 
*Zipcode
*Phone:
( )   - Ext.
Fax:
( )   -
Nextel:
( )   -
Cell:
( )   -
*Email:
Owners, Officers > Complete this section:
*First Officer Name & Title:
*First Officer Address:
*First Officer Social Security Number:
*Second Officer Name & Title:
*Second Officer Address:
*Second Officer Social Security Number:
*Third Officer Name & Title:
*Third Officer Address:
*Third Officer Social Security Number:
*Name of person to contact for additional information:
*Phone:
( )   - Ext.
Major Building Material Trade References:
*First Trade Ref. Name:
*First Ref. Phone:
( )   -
*Second Trade Ref. Name:
*Second Trade Ref. Phone:
( )   -
*Third Trade Ref. Name:
*Third Trade Ref. Phone:
( )   -
*Fourth Trade Ref. Name:
*Fourth Trade Ref. Phone:
( )   -
Bank Information
*Bank Name
*Account Number
*Bank Contact
*Branch Phone:
( )   -
*Credit Limit Desired (Monthly)
*How long have you been in business? (date)
Please list a recent job, or future concrete needs
* For Residential Builder or Individual building own home:
*Street Address
Lot#
*Subdivision
*County
*Estimated cost to build
*Square footage
*Construction loan amount
*Closed?
Yes No Other:
*Bank Name:
*Loan Officer
*Branch Phone:
( )   -
* For Commercial Contractor, Subcontractor, or Remodeler:
*Job Name
*Prime Contractor
*Job Address
*Owner
*Anticipated product amount to purchase from TUCCO:
*Project bonded?
Yes No
*If so, name of bonding company
*Address
*Phone:
( )   -
*Do you require a Purchase Order (PO) to conduct business?
Yes No
*What is your procedure?
Remarks: (anything that will help expidite processing this application)
Provisions for Credit

This application serves as a request for the extension of credit. The Applicant authorizes Tucker Concrete Company, Inc. (thereafter referred to as “TUCCO”) to obtain credit reports, as needed, from any credit reporting agency. Applicant authorizes any bank, or commercial business, to give TUCCO all necessary information which will assist in the credit investigation. In addition, Applicant further authorizes TUCCO to reinvestigate the Applicants credit status as TUCCO deems necessary. TUCCO reserves the right to restrict, or terminate, any credit extension to applicant.
The undersigned hereby certifies: 1) he/she is authorized to sign application for Applicant; 2) the information contained herein is true. The Applicant will advise TUCCO in writing of any future changes to the information contained with this application. Until correct information is provided, TUCCO may continue to rely on the information on file. Applicant will pay obligations when due and all indebtedness that he/she may now or hereafter owe TUCCO, with all cost of collection including 15 percent of the principal and interest as attorney’s fees if collected by law or through an attorney at law. For any non sufficient fund checks, Applicant shall pay TUCCO a charge of $25 or 5 percent of the amount of any non sufficient check given for payment toward any indebtedness, whichever is greater. Applicant acknowledges TUCCO may elect to file materialman’s liens to enforce collection rights. In most cases, all invoices are subject to lien after 60 days. Applicant agrees all filings costs, including attorney’s fees incurred, shall be a part of the indebtedness Applicant may now or hereafter owe TUCCO. Applicant agrees all filing costs, including attorney’s fees incurred, shall be a part of the indebtedness Applicant may now or hereafter owe TUCCO. Applicant agrees to the following terms and conditions. All purchases shall carry terms of sale for materials. All purchases not paid in full, within thirty (30) days of the Net due date will be assessed at 1-1/2 percent per month finance charge (which is 18 percent annually) until paid. Applicant acknowledges TUCCO may apply payments to the oldest open items, unless specified otherwise on the remittance statement copy.
The Credit Application Agreement shall be construed and governed according to the Laws of Georgia.

*Authorized Signature
*Title of Person Signing
*Name of all Accounts to be Established
Continuing Guaranty

In consideration of the credit extended to the Applicant, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the undersigned (jointly and severally if more than one), unconditionally guaranty the payment when due of all indebtedness now due or which may become due by Applicant to Tucker Concrete Company, Inc., together with all collection costs including 15 percent of all indebtedness as attorney’s fees if collected by or through an attorney at law.

The undersigned waive presentment for payment, notice of non payment, protest to any extension of time and all other notices and agree that this Guaranty may be enforced without any prior proceeding against the Applicant.

No modification or revocation of this instrument shall be effective unless in writing and signed by the undersigned and an authorized officer of Tucker Concrete, Inc.

This Guaranty shall inure to the benefit of Tucker Concrete Company, Inc.’s successors and assigns and shall be binding on the heirs, executors, and administrators of the undersigned.

In witness whereof, the undersigned have hereunto set their hand and affixed their seal the date set forth below.
(THIS IS A PERSONAL OBLIGATION; DO NOT CORPORATE OR OTHER TITLES)

*Signature of Guarantor (No Titles) Signature Date (MM/DD/YY):
*Witness: