CHRIS LAPI MOVING SUPPLIES, INC.
CONTACT INFORMATION:
Name:
Address:
City: State: Zip:
Phone: Fax:
E-mail:
 
BUSINESS INFORMATION:
Business Type:

: State

How long in business: D&B Number:
 
NAME/ADDRESS OF INDIVIDUALS OR PARTNERS OR NAME/TITLE/PHONE NUMBERS OF CORPORATE OFFICERS:
 
NAME OF PERSON TO CONTACT REGARDING ORDERS & INVOICES: TITLE, ADDRESS, & PHONE:
 
ADDITIONAL INFORMATION:
Are purchase orders required? Is your company tax exempt?
 
BANK INFORMATION :
Bank Reference Bank Name: Account Number & Phone Number
Credit Card Information Number, Expiration date, & Billing Address
 
3 TRADE REFERENCES: COMPANY NAME, FAX NUMBER, & CONTACT
Trade Reference #1:
Trade Reference #2:
Trade Reference #3:
 
Comments/Special Requests :
 

 

Chris Lapi Moving Supplies inc © 2007-2008. All rights reserved.