The Common Market Credit Application

Dear Prospective Customer,

We appreciate your interest in purchasing from The Common Market.

In order to secure an easy payment process, please review the payment options below and indicate which works best for you, and continue to the next page to fill out the remainder of the application. We will contact you when your credit application has been approved. Thank you!

We offer the following payment methods:

1. ACH Credit (Preferred Method) You are requesting to transfer money from your account to The Common Market's account, often referred to as a “push”.

2. ACH Debit (Preferred Method) You are giving The Common Market approval to withdraw money from your account, often referred to as a "pull."

o Contact The Common Market to obtain/send ACH transfer information at finance@thecommonmarket.org or by phone: 215-275-3435 ext. 341

o Remittance information must be emailed to finance@thecommonmarket.org

3. Check by Mail

o Memo includes invoice number(s)

o Check made out to The Common Market, mailed to:

The Common Market

LBX # 2153

PO Box 95000

Philadelphia, PA 19195-0001

4. Bill.com

o app.bill.com/network/commonmarket

o Payment Network ID (PNI) = 0166503521995066

5. Payment with Credit Card

o A 3% processing fee will be added as a line item to each invoice

Legal Business Name

DBA Name (if applicable)

Business Address

Street

City

State

Zip Code

Business Type

CorporationPartnershipIndividual

Principal Officer Name

Phone Number

Accounts Payable Information

Billing Contact Name

Phone Number

Email Address

Trade References - Three (3) Current, Foodservice Vendors

Please provide contact information for three current food service vendors.

1) Company Name

Contact Name

Contact Phone Number

Contact Email Address

2) Company Name

Contact Name

Contact Phone Number

Contact Email Address

3) Company Name

Contact Name

Contact Phone Number

Contact Email Address

Your Signature

By typing by name in the box below, I agree that the above information is provided for extending credit to our company on Terms stated on the submitted Customer Agreement.

To the best of our knowledge and belief, the information is accurate and may be relied upon in making your credit decision. We authorize our bank and suppliers to furnish any information necessary to complete your evaluation of our credit history.

Name:

Date

Title

Contact Information