CREDIT APPLICATION

 Legal Business Name: 

__________________________________________________________________

 Mail To Address:  ___________________________________________________

__________________________________________________________________
   
Ship To Address:   ___________________________________________________

__________________________________________________________________ 

Phone Number:    (_____)_____________________ 
  
Fax Number:          __________________________

Check One:     (  ) Sole Proprietorship     (  ) Partnership     (  ) Corporation      (  ) S-Corporation

Federal ID #:  ____________________ Sales Tax Exempt:  (  ) No   (  ) Yes  
 
Exempt #:  ____________________

Credit Amount Requested:  ______________ Annual Sales:  _____________

Net Worth:  ____________

 IF MORE THAN TWO OWNERS, PLEASE ATTACH ADDITIONAL SHEET WITH REQUIRED INFORMATION. 

Owners Name:  ___________________________________ 

Home Address:  __________________________________                                  

Social Security Number:  ____________________________

Owners Name:  ___________________________________  

Home Address:  __________________________________
 
Social Security Number:  ____________________________

 Name of Bank:  _________________________________ 
 
Account #:  _____________________________________

Contact Name:  ___________________________________  

Phone Number:  ___________________________________

 TRADE REFERENCES:

 1.) Supplier:  _________________________________________  

 2

       Phone #:  _________________________________________       

       Fax #:      _________________________________________       


3.) Supplier:  _________________________________________  

      Address:  _________________________________________        

       Phone #:  _________________________________________       

       Fax #:      _________________________________________      


 4.) Supplier:  _________________________________________  

      Address:  _________________________________________        

       Phone #:  _________________________________________       

       Fax #:      _________________________________________       

 TERMS AND CONDITIONS OF CREDIT

 In consideration of the extension of credit to the applicant by THE VENDING CENTER, INC., the applicant agrees that with respect to all purchases made by the applicant, the applicant shall be liable for the entire unpaid balance owing.

 Our credit terms are NET 30.  Applicant agrees to pay all invoices within these terms.  Any terms outside of this shall be agreed upon in writing and strictly adhered to.

 Furthermore, if the applicant defaults in payment, the applicant shall pay all cost of collection, including the cost of a collection agency, and /or a reasonable attorney’s fee.

 The amount of any credit limit established by THE VENDING CENTER, INC. may be reduced at any time by THE VENDING CENTER, INC.; and THE VENDING CENTER, INC. may limit purchases by applicant at any time.

 Applicant must submit in writing to THE VENDING CENTER, INC. any pending change in ownership at least thirty (30) days prior to change.  Also, any credit that may be extended to applicant is nontransferable upon change of ownership.

 This application is submitted to obtain credit, and the applicant certifies that all information herein is true and complete.  The applicant also authorizes THE VENDING CENTER, INC. to conduct further investigation and obtain additional information concerning applicant’s credit reputation from all available sources from time to time.  By signing this application, applicant shall be deemed to have agreed to and accepted the terms and conditions set forth above.

 NAME OF APPLICANT:   _____________________________________

OWNER OR OFFICER’S SIGNATURE: ___________________________

 Date Business Established:  _________________________

  PLEASE ATTACH A COPY OF YOUR SALES TAX EXEMPT CERTIFICATE IF APPLICABLE.  THIS EXEMPTION SHOULD BE FOR RESALE OF EQUIPMENT OR PARTS, NOT VENDING PRODUCT IN THE EQUIPMENT.

 PLEASE ATTACH A COPY OF YOUR MOST CURRENT FINANCIAL STATEMENTS.

 GUARANTY OF PAYMENT 

   BIRMINGHAM, ALABAMA

   DATE:_____________________

      The undersigned hereby separately and severally guarantee to THE VENDING    

CENTER, INC., an Alabama corporation (herein called the “Vending Center”),  

the payment and performance of any and all debts and obligations now owing by  

__________________________________, a ____________________________

(herein called the “Principal Debtor”) to the Vending Center and any and all debts

 and obligations now owing or hereafter contracted or incurred, by the Principal

 Debtor to the Vending Center.

      It is agreed that the Vending Center may, in its sole and absolute discretion, at        

 any time take renewals of any debts or extend the time of payment of any debt at any

time owing to it by the Principal Debtor without notice or consent of the undersigned

without in any way impairing or affecting the obligations of the undersigned on this

contract of Guaranty, and the liabilities of the undersigned under the terms of this

 guaranty shall, and are hereby made to extend to all such renewals or extensions.  Any

 and all collateral, security, guaranties and other obligors, if any, may, from time to      

 time, without notice to or consent of the undersigned, be sold, released,

surrendered, exchanged, settled, compromised, waived, subordinated or modified, with
 
or without consideration, on such terms or conditions as may be acceptable to the

Vending Center, without in any manner affecting or impairing the liability of the

 undersigned.  This is a continuing  guaranty.  This guaranty shall extend to all debts,
 
including extensions, modifications and renewals contracted or owing by the Principal

Debtor to the Vending Center.  

      In the event that the Principal Debtor should at any time make default in the

payment of any debt owing to the Vending Center when the same becomes due, the

undersigned agrees to pay such debt at once, and upon failure of the undersigned to       

do so, the Vending Center may in its discretion, enforce the collection of such debt       

out of the undersigned by suit in court, or in any other way provided by law,

the same as if such debt were the primary and individual debt of the undersigned, and

without first seeking to enforce the said debt by suit or otherwise out of the Principal

Debtor; or the Vending Center may, in its sole and absolute discretion, proceed in any

manner provided by law for collection of debts against either or both the undersigned

and the Principal Debtor the same as if such debt were primarily and individually the

debt of both the undersigned and the Principal Debtor.  The undersigned agrees to       

pay all costs of collection, including, but not limited to, court cost and reasonable

attorney’s fees, and hereby waives all rights of exemption under the laws of Alabama

and the United States of America.  The undersigned hereby waives presentment,

protest, notice and demand with regard to every debt guaranteed hereunder.  It is

agreed that every term, provision and condition of every note or other evidence

of debt, including extensions, modifications and renewals, executed by the Principal

Debtor to the Vending Center shall become a part of this obligation as if fully set

out herein and shall bind the undersigned as if it were executed by the undersigned

as the primary and individual obligation of the undersigned.  The obligations of the

undersigned shall be effective regardless of the solvency or insolvency of the Principal

Debtor at any time, the extension or modification of the indebtedness of the Principal

Debtor by operation of law, or the subsequent incorporation, reorganization, merger or

consolidation of the Principal Debtor by operation of law, or any other change, in the

composition, nature, personnel, or location of the Principal Debtor.  All liabilities of

 the Principal Debtor and of the undersigned shall mature immediately upon the

insolvency of the Principal Debtor, the appointment of a receiver for the Principal 

Debtor of any of its property, the filing of a voluntary or involuntary petition in

bankruptcy, reorganization, or arrangement, the making of an assignment for the

benefit of creditors, or the calling of a meeting by the creditors of the Principal  

Debtor.  

     It is agreed that the liability of each of the undersigned is several.  In the event

of the termination of this guaranty as to any one or more of the undersigned, this

agreement shall continue in full force and effect as to the remaining guarantors.

     This guaranty shall be binding upon the undersigned and the heirs, executors,

administrators, successors, and assigns of the undersigned, and shall inure to the

benefit of the Vending Center, its successors and assigns.

     It is the intent of the Vending Center and the undersigned that this guaranty is the

entire integrated guaranty agreement between the parties into which all negotiations,

representations and inducements occurring between the Vending Center and the

undersigned in connection herewith are merged.  This Agreement may not be modified

except by written agreement signed by the Vending Center and the undersigned.

 _____________________________________ Date:___________

OWNER:
                                                               _____________________________________ Date:____________

WITNESS:

PLEASE FAX BACK FORM TO :205-426-5656

OR MAIL TO :

P.O.BOX 28663
MIDFIELD, AL 35228