House Account
Application

Business Information

Name of company*

Billing contact first name*

Billing contact last name*

Email address*

Phone number (XXX) XXX-XXXX*

Accounts Payable email*

Email for invoices (if different)

Billing address info

Street address*

Floor or suite number

City*

State*

Zip code*

Business profile information

Anticipated spend ($)*

Per Year

Employee count*

Public Company?*

Yes

Tax exempt?*

Yes

Tax exempt ID number*

Please upload your tax exempt form*

Upload File

PO # Required for Orders?

Yes

Preferred Ordering Methods?*

Catering

Group Ordering

Preferred restaurant location(s)*

D&B Number or Credit References

Authorized emails (comma separated)

Additional notes

Method of payment

Select method of payment*

ACH

Mail a check

Automated Clearing House (ACH)*

Routing account number

Terms & conditions of credit agreement

Expected catering spend is $12,000 per calendar year for catering customers and $5,000 per calendar year for group ordering customers.
The person listed as Billing Contact on this application is the person responsible for administration of the house account and ensuring that invoices are paid in full and according to terms of this agreement. The Company is responsible for full payment.
Statements will be sent every calendar month by Founders Table Accounting.
This house account may be put on hold or deactivated for non-payment of outstanding balances without notice.
Either party can terminate this Agreement at any time for any reason with a written notice.
The invoice amount is due and payable to Founders Table within net- 30 days.
Statements will be sent once per month.
The undersigned represents that he / she has been authorized by the Company to enter into this Agreement.
Changes to point of contact, company name or any pertinent information are the responsibility of both parties to inform.

Authorized signatures

Signature (type full name)*

Job title*

Email*

By checking this box, I agree and certify that my printed signature is my signature in this electronic application.

By checking this box, I state that I have read the House Account Application and Credit Agreement and agree to the terms set forth in this agreement. I agree that I am an authorized representative of the above referenced Company, Organization, or Institution.

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