Customer credit application

Thank you for choosing XColdChain for your temperature-controlled freight. Please complete every section, sign at the end, and return this application with a W-9 to AR@xcoldchain.com. This form can be filled in on screen or printed.

XColdChain LLC 417 Jones Rd, Spartanburg, SC 29307
(803) 408-4454 · AR@xcoldchain.com

Shipper business information

Legal business name

DBA / trade name

Physical address

City

State

ZIP

Mailing address (if different)

City

State

ZIP

Main phone

Website

Federal tax ID (EIN)

Business type (Corp / LLC / Partnership / Sole prop.)

State of incorporation

Year established

Products shipped (produce, frozen, meat, dairy, beverage, other)

Range of cargo value per load ($)

Owner / principal name

Title

Phone

Shipper accounting & billing information

Accounts payable contact name

Title

Phone

Invoice submission email or portal URL

Portal login / instructions

Billing address (if different)

City

State

ZIP

Required on every invoice

Preferred payment method (ACH / check / wire / card)

Payment terms requested

Credit amount requested ($)

Customer credit application · continued

Shipper accounting & billing (continued)

Sales tax exempt? (Yes / No — attach certificate)

YesNo

Your carrier / vendor setup packet required? (Yes / No)

YesNo

Secondary accounting / controller contact

Phone

Bank reference

Bank name

Branch address

Bank contact name

Phone

Account type (checking / savings)

Last 4 digits of account

Length of relationship

Terms and conditions of credit

By signing below, the applicant (“Customer”) agrees to the following if credit is extended by XColdChain LLC (“XColdChain”):

Payment terms. Invoices are due Net 30 from the invoice date unless XColdChain approves different terms in writing.
Charges. Customer pays the linehaul rate plus all accessorial charges on the rate confirmation, including detention, layover, lumper, TONU, extra stops and fuel surcharge.
Collection costs. Customer pays reasonable collection costs and attorney fees incurred to collect past-due amounts.
Disputes. Billing disputes must be raised in writing within 15 days of the invoice date. Undisputed amounts remain due on time.
Credit limit and review. XColdChain may set, change, suspend or revoke credit at any time, and may require prepayment.
Credit investigation. Customer authorizes XColdChain to contact the bank reference above and to obtain credit reports on the business.
Assignment. XColdChain may assign invoices to a factoring company. Customer agrees to pay the assignee named on the invoice or notice of assignment.
Accuracy. Customer certifies the information in this application is true and complete, and will notify XColdChain of any change in ownership, name or address.

Authorization and signature

The undersigned is authorized to sign on behalf of the Customer and agrees to the terms above.

Authorized signature (type full legal name)

Date

Printed name

Title

For XColdChain use only

Date received

Credit limit approved ($)

Terms approved

Approved / declined

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