Eco-Maxx Fluid Resources, LLC Confidential Business Credit Application Salesperson Acct. # Date Company Information Name of Business Tax ID Number Address City State Zip Phone Type of Business In Business Since Legal Form Under Which Business Operates CorporationPartnershipProprietorship Principal Owner Information Last Name First Name Middle Initial Title SS# Address City State Zip Phone Bank Reference Institution Name Checking Account No Bank Address and Phone Trade Reference 1 Company Name Contact Name Address Phone Fax Trade Reference 2 Company Name Contact Name Address Phone Fax Trade Reference 3 Company Name Contact Name Address Phone Fax This is to certify that our firm is financially able to meet any commitments we have made and to pay our invoices according to terms (NET 30). We agree to pay a minimum service charge of 1.5% per month on all past due invoices. Eco-Maxx Fluid Resources, LLC retains the right to withhold and/or deduct any contra balance owed to purchaser if account is past due. Any account classified as past due at that time will be placed on C.O.D until the account is returned to a current status and/or the credit line is re-evaluated. Purchaser agrees to pay all costs of collection, including a reasonable attorney's fee should legal action be necessary. I hereby certify that the information contained herein is complete and accurate and authorize Eco-Maxx Fluid Resources, LLC to verify this information. Signature Title (Officer of Company) Date Guaranty In consideration of granting credit to the Applicant, the undersigned hereby guarantees to Eco-Maxx Fluid Resources, LLC and to its heirs, successors and assigns, the payment of any and all balances due by the Applicant on this account or any account of any successor to this Applicant including service/finance charges, collection costs and reasonable attorney's fees. Date Name Signature