Carolina Concrete
P O Box 389
Clinton, SC 29325
Phone (864) 833-0572 Fax (864) 833-2398
Terms of Use
Concrete 101
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Copyright 2006 Carolina Concrete
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Copyright 2006 Carolina Concrete
Fill out them form below to apply for an open credit account with Carolina Concrete. If you prefer you can download the credit application from HERE, and mail it to the address at the bottom of the page.
Application for Open Account
 * Required Field
*
 Name of Business:
*
 Address:
*
 City:
 *
 State:
 *
 Zip Code:
*
 Business Phone:
 Fax:
 EIN:
Date Founded:
 Corporation
 Proprietorship
 Partnership
If incorporated, list officers:
 President
 V.President
Secretary
 Treasurer
 Other
Tax Exempt:
 Yes
 No
 If yes, Tax No.
 (enclose certificate)
Purchase Orders:
 Yes
 No
 Please forward names of authorized purchasers.
Bank References
Name
 Address
Phone
 Officer
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Name
 Address
Phone
 Officer
Credit Information
(1)
 Name
 Phone
 Fax
Address
 City
 Zip Code
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(2)
 Name
 Phone
 Fax
Address
 City
 Zip Code
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(3)
 Name
 Phone
 Fax
Address
 City
 Zip Code
Personal Guarantee
In consideration of Carolina Concrete Company, Inc. agreeing to extend credit to
, the undersigned, d.b.a.
hereby agrees to personally quarantee and be responsible for any indebtedness incurred.
Further, the undersigned agrees to render payment on account by date due as prescribed by the 10th of the month following
the invoice date. A finance charge of 1.5% per month will be added to the unpaid balance of all accounts receivable over 30
days old.

Further, the undersigned agrees to pay any and all legal and/or court costs relating to the collection of a past due account.
Any late payment will result in C.O.D. status and a review of credit standing.
Type Your Name:
Date:
By typing your name you are electronically signing a legal contract for consideration of credit.