Neck Pain
Application for Credit
 
  The undersigned for the purpose of obtaining credit now and thereafter, submits to RS Medical®, INC., for its reliance thereon, the following representations which are complete, accurate and truthful. In the event of any substansial change in the following representations, the undersigned promised to immediately notify RS Medical®, INC.
   
 

Business Name  
Business Form: Corporation Partnership Sole Owner Other
Mailing Address:
 
Physical Address:
 
Telephone:      Fax:
Customer toll free number:
Email:
Internet Site:
Contact Names:    
Sales:    
Accounts Payable:    
Trade References:    
1. Company Name:
Account #:
Telephone #:
Fax #:
   
2. Company Name:
Account #:
Telephone #:
Fax #:
   
3. Company Name:
Account #:
Telephone #:
Fax #:
   
4. Company Name:
Account #:
Telephone #:
Fax #:
 
Company Offciers (Name / Position):
President/Owner:
Chief Executive Officer:
Chief Financial Officer:
   
Type of Business:  
Tax Exempt Certificate Number:
Do you have a catalog?  
If yes, who can we contact regarding advertising for your catalog?
Name:      Phone:      Ext:
Do you bill insurance for your customers/patients? Yes No
If yes, which insurance companies are you contracted with?
Number of outside Sales people:
Medical Professionals Called Upon: MD PT DC Hospital
Describe your geographical territory (Used to forward sales leads):
In consideration of RS Medical®, INC. extending credit to the undersigned applicant, the applicant agrees to pay for all items delivered at its request of an employee, in accordance with the terms set forth below, and the provisions of the TERMS OF SALE of RS Medical®, INC., a copy of which has been supplied to the application as an integral part of this document, the receipt of which is hereby acknowledged.

All accounts are due and payable in U.S. Funds at the remittance address shown on the invoice within 30 days following the invoice date, or as separately agreed, in writing, between RS Medical®, INC. and the applicant.

By signing below, applicant agrees to pay a Service Charge computed at the rate of 1% per month, or higher if allowed by law, may be charged on all sums due following the due date. The Service Charge shall be due and payable on the first day after the due date, and will continue to accrue on the unpaid balance at the rate of 1% per month of the maximum allowed by law, whichever is higher.

In the event that RS Medical®, INC. employs a collection agency or attorney in order to secure payment of any sums due it from applicant, does hereby personally, for himself or his marital community, guarantee all charges, service charges, interest, fees , and other costs, including but not limited to attorney's fees.

Further, in consideration of RS Medical®, INC. extending credit to applicant, the undersigned, being as Owner or President of applicant, does hereby personally, for himself or his marital community, guarantee all charges, service charges, interest, fees, and other costs, including but not limited to attorney fees.

Applicant further authorizes RS Medical®, INC. to obtain any and all credit financial information concerning the applicant at any time and from any source.
 
TERMS OF SALE


1. COMPLETE AGREEMENT: Unless there has been an Order Acknowledgment, or other written agreement by RS Medical® INC. ("Seller"), which is binding, the sale of goods to Buyer, as evidenced b Quotation/Invoice, shall be only upon the terms stated herein. Any additional or different terms proposed by Buyer are hereby rejected.

2. MODIFICATION: No modification of these terms shall be binding upon Seller unless agreed to in writing by Seller.

3. TAXES: Prices do not include sales, excise, use or other taxes or fees now in effect or hereafter levied which Seller ma be required to pay or collect in connection with the sale of goods to Buyer; all such taxes and fees shall be for the account of Buyer who shall promptly pay Seller upon demand.

4. REPRESENTATION OF SOLVENCY: Buyer represents and warrants that it is solvent.

5. PAYMENT: Terms of payment shall be 30 days following invoice date unless otherwise specified on the invoice or agreed to in writing. Seller reserves the right to change the terms of payment or to require payment prior to receipt of goods if, in Seller's opinion, Buyer's financial condition or other circumstances so warrant. Overdue payments shall be charged interest at the rate of 12% per annum. If seller retains a collection agency or attorney to collect overdue payments, all collection costs, including reasonable attorney fees, for consultation, trial and appellate levels, shall be payable by Buyer. Any court of competent jurisdiction in Flathead County, Montana shall be proper venue for any and all suits or actions brought for any and every breach of this contract.

6. INSPECTION: Buyer shall promptly inspect the goods upon receipt and either accept them or reject them. Buyer will be deemed to have accepted the goods if the Buyer fails to give written notice of rejection within ten (10) days of receipt of goods.

7. EXCLUSION OF WARRANTIES/REMEDIES: Seller warrants that the goods, at the time of delivery to Buyer, shall be as described on the face of the invoice. This warranty is conditioned upon Buyer giving Seller written notice of any defect within thirty (30) days of delivery of goods or, in the case of defects not discoverable through inspection, within thirty (30) days of discovery or one hundred twenty (120) days of the invoice, whichever is sooner. EXCEPT AS EXPRESSLY STATED HEREIN, THER ARE NO WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING, WARRANTIES OR MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND WARRANTIES ARISING FROM COURSE OF PERFORMANCE, COURSE OF DEALING, USAGE OF TRADE OR SAMPLES PREVIOULSLY SUPPLIED. Seller's obligation and liability under the warranty expressly stated is limited solely, at Sellers option, to (a) repair or replacement of defective goods, or (b) repayment of or reduction in a reasonable portion of the defective goods' purchase price. Buyer's exclusive remedies are those expressly stated herein. No goods shall be returned without Seller's consent. Seller shall not be liable to Buyer for any special, indirect, incidental or consequential damages resulting from breach of warranty or any other terms of sale, for any liability of Buyer to any third party, or for any liability in tort, whether or not arising from the negligence of Seller.

8. ASSIGNMENT: No assignment of rights or delegation of duties shall be binding upon Seller without its written consent.

9. APPLICABLE LAW: The sell of goods shall be governed by the laws of the State of Montana.
Minimum Advertised Price Policy (MAP)
In order to protect RS Medical®, Inc.'s reputation for superior quality products, RS Medical®, Inc. has adopted a Minimum Advertised Price Policy for its products. The policy states as follows:

     RS Medical®, Inc. has established a Minimum Advertised Price for all RS Medical®, Inc. products. With respects to products for which a Minimum Advertised Price is specified on the current RS Medical®, Inc. Price List, it is RS Medical®, Inc.'s unilateral policy to allow twenty-four (24) hours to bring advertising into compliance or RS Medical®, Inc. will cease supplying for a period of fourteen (14) days, the product in question to any dealer whose advertising of the product (or any distributor who sells to a dealer whose advertising of the product) (i) fails to display price equal to or greater than the Minimum Advertised Price for the product as specified on the current RS Medical®, Inc. price list. (ii) contains a price lower than the Minimum Advertised Price set forth in the current RS Medical®, Inc. Price List. RS Medical®, Inc.'s unilateral policy is to cease supplying for a period of thirty (30) days for any second violation, sixty (60) days for any third violation and one (1) year for any subsequent violation of this policy as noted above.

     This policy applies to all forms of patient advertising including, without limitation, the Internet and any other electronic network. Any price information relating to RS Medical®, Inc. products on an Internet website which can be accessed directly through any hypertext link or by any other method which uses the hypertext transfer protocol (http) is considered to be advertising for purposes of this policy. Electronic mail sent in direct response to a customer inquiry is not considered to be advertising.

     This policy only concerns advertised prices, and does not relate to actual sales prices of any item. Further, this policy applies equally to all RS Medical®, Inc. distributors and dealers.

The foregoing is a statement of RS Medical®, Inc.'s unilateral policy and expresses the terms upon which we will deal with our customers. This policy may be modified by RS Medical®, Inc. from time to time. RS Medical®, Inc. does not seek, nor will it accept, any agreement or understanding with respect to the prices you may advertise or charge at any time.
   
 
 
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