Credit Application | Premier Trailer Leasing

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1 Applicant Information
2 Company Information

Step 1: Applicant Information

Applicant Name *

Applicant Email Address*

Applicant Phone Number *

Step 2: Company Information

Company Name *

Website

Please use your full website address; e.g. https://example.com

Contact Name *

Contact Phone Number*

Contact Email Address

Physical Address *

City *

State *

Zip *

Main Phone *

Alternate Billing Address

Check if same as above.

Billing Address *

Billing City *

Billing State *

Billing Zip *

Billing Contact Name *

Billing Contact Phone *

Billing Contact Email *

E-Mail Invoices to: *

PO # Required? *

Yes

Tax Exempt? *

Yes

Tax Exempt Certificate *

Note: A file name can't contain any of the following characters: \/:*?<>|+ ' &

DOT #

MC #

Federal ID # *

Years in Business

# of Employees

Federal ID Documents

Note: A file name can't contain any of the following characters: \/:*?<>|+ ' &

Insurance Information

Notice: We require a valid current insurance certificate prior to release of any trailers, naming Premier Trailers LLC & ISAA as Additional Insured for Liability and Loss Payee for Physical Damage.

Our Insurance Requirements are as Follows:

Minimum of $1 Million Combined Single Limit (CSL) liability coverage. (GL,AL)
Physical Damage Coverage - Or you may choose Premier's Loss Damage Waiver program. Click here for more details.
Premier Trailer Leasing must be named as Additional Insured for Liability and Loss Payee for Physical Damage.
Certificate Holder Information: Premier Trailers LLC & ISAA

Insurance Company

Contact Name

Phone Number

Please select the Equipment Types you are interested in Renting/Leasing.

Please indicate location from which you are most likely to pick up *

Number of Trailers *

Please specify the number of trailers that you would like to be approved to rent/lease.

Additional Information

Additional Information (Optional)

Additional Documentation

Note: A file name can't contain: \/:*?<>|+ ' &

Add another

Authorization and Acknowledgement

The information provided above is true and complete. Premier may receive from and disclose to other persons, including credit reporting agencies about Applicant and/or Business Owner's account and credit experience, and Applicant and/or Business Owner authorizes any person to release to Premier Trailer Leasing credit experience on Applicant and/or Business Owner made by Premier Trailer Leasing, or any person requested to release such information.

In Consideration of being allowed the privilege of an open credit account, the undersigned, an authorized representative for the above named company applying for credit, hereby agrees and accepts the General Terms and Conditions of Premier Trailer Leasing, including but not limited to Premier Trailer Leasing's payment terms as listed in the General Terms and Conditions.

To view the General Terms and Conditions in a new window click here.
You may also save a copy of the General Terms and Conditions for your records.

In case of default in payments, Premier Trailer Leasing shall be entitled to exercise remedies, in addition to all other rights permitted by law:

To assess late fees and/or interest
To submit the debt to a collection agency
To report the debt to all major credit bureaus
The Customer agrees to pay all costs of collection, including reasonable attorney's fees

This agreement and electronic acceptance shall be governed by the laws of the State of Texas.

Authorized Representative First & Last Name *

Title *

Date

Click Here to View Terms and Conditions

Customer Agreement

I Accept the Terms and Conditions

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