New Customer • Key Mechanical

Legal Business Name: *

DBA/Trade Name:

Form of Organization:

Type of Business

Key Mechanical Primary Contact:

Bill To Address: *

Address Line 1

City

State

Zip Code

Same Service Address

Yes

Service Address:

Address Line 1

City

State

Zip Code

Years in Business:

Tax Exempt: *

Yes
No

Tax Exempt Certificate (PDF Format Only):

Click or drag a file to this area to upload.

Phone: *

Website / URL:

Accounts Payable Contact

AP: Name: *

AP: Phone: *

AP: Email Address: *

Is a Purchase Order Required? *

Yes
No

Billing Preference: *

Email
Mailed Hard Copy
3rd Party System

You can select multiple options

3rd Party Billing System:

Business Principals

Name/Title:

Additional Contact (Optional)

Name/Title:

Phone:

Email:

Additional Service Locations

For more than 10 additional service locations Key Mechanical will contact the person indicated on the form for a list of addresses

Additional Location 1

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 2

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 3

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 4

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 5

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 6

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 7

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 8

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 9

Address Line 1

Address Line 2

City

State

Zip Code

Additional Location 10

Address Line 1

Address Line 2

City

State

Zip Code

Terms of Payment *

I Agree

You will be invoiced upon completion of the work and is due upon receipt. Past due accounts are subject to a monthly service charge of 1.5% on the unpaid balance. Customer agrees to pay all collection agency fees, including reasonable attorney fees if customer should default on timely payment. If Customer wishes to pay any amounts due via credit card, Key Mechanical Co. must pre approve method of payment and Customer agrees to pay a minimum of 4% of the payment for any additional credit card service fees incurred on the total amount paid. All claims, requests for adjustments or notification of errors must be made within thirty days of invoice date or charges are considered accepted. Credit privileges may be withdrawn at any time without invalidating the terms of this agreement. In the case of any suit brought as a result of service provided and sales made to the customer, venue of said suit may be laid in the county of residence of the holder.

Accounts Payable Contact

Business Principals

Additional Contact (Optional)

Additional Service Locations

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