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How to Open Your Account in MaxMed Labs

Set up an account before or with the placement of your first order. Please fill out the  application form below for a new account and send to:

Customer Service Dept.
MaxMed Laboratories, Inc.
8370 Juniper Creek Lane, #1
San Diego, CA 92126
USA

Fax:    (858) 271-5388

Email: Sales@maxmedlabs.com

 

 

 

MAXMED LABORATORIES, INC.
8370 Juniper Creek Lane, #1
SAN DIEGO, CA 92126
TEL  (858) 271-8118
FAX (858) 271-5388
EMAIL: sales@maxmedlabs.com
www.maxmedlabs.com

APPLICATION FOR NEW ACCOUNT

Company Information:

Company Name: __________________________

Shipping Address: _________________________

Billing Address: ___________________________

_________________________

 ___________________________

_________________________

 ___________________________

Fed Ex Account #: _________________________

Phone Number: (_____)_____________________

Fax #: (_______)__________________________

IRS Tax ID#:  _____________________________

Seller's Permit # (Resale): ___________________

Bank Information:

Bank:   __________________________________

Account #: _______________________________

Address: ________________________________

Contact: _________________________________

________________________________

Phone #: (________)_______________________

________________________________

 

Trade Reference:

Company: ________________________________

Contact: _________________________________

Account #: _______________________________

Phone #: (________)_______________________

Company: ________________________________

Contact: _________________________________

Account #: _______________________________

Phone #: (________)_______________________

Company: ________________________________

Contact: _________________________________

Account #: _______________________________

Phone #: (________)_______________________

I (we) promise to pay our account in full within 30 days terms. If this account is not paid as agreed a delinquency charge shall be computed at the rate 1.5% per month, 18% annum on unpaid balance.

I (we) know that all shipments are F.O.B. Origin, San Diego, CA 92126 and buyer sole responsibility to provide for insurance coverage. The shipping under refrigeration will be charged $20 packing fee for each insulated foam container with ice bag and the $15 handling fee for each free sample requirement. A $10 export fee per oversea shipment will be charged for any item with customer value more than $2,500.

You are authorized to contact any of the above references regarding our credit sanding. I (we) have read the above terms and conditions and agree to abide by them.

Signature:

_____________

_____________

________________

_____________

(Authorized)

(Print Name)

(Title)

(Date)




 

 
                       
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