Application for Credit

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BUSINESS INFORMATION:









Tax Exempt Certificate Required     State:

               
               
                   
               
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Please enter at least one principal.
Full Name Social Sec. Number Address City State Zip

Please provide three business references.
Name of Business Contact Address Phone






This GUARANTY is given by the applicant, jointly and severally, to Dominion Electric Supply Company, Inc., Dominion Electric Supply Company of Washington, LLC, their divisions, subsidiaries, affiliates, successors and assigns (hereinafter referred to as "Dominion") in order to induce Dominion to extend credit to or otherwise become a creditor of the Purchaser, its successors and assigns.

I/WE do absolutely and unconditionally PERSONALLY GUARANTEE to Dominion the prompt payment, when due, of every claim of Dominion now existing or which may hereafter arise against the Purchaser, its successors and assigns, including all costs of collection, including attorney's fees of thirty-three percent (33%) of the amount due when placed for collection, whether or not suit is brought against Purchaser and/or the applicant.

This is a continuing GUARANTY and shall remain in full force until revoked by Guarantor(s) by notice in writing to Dominion by certified mail, said revocation effective only as to the claims of Dominion arising out of transactions entered into with Purchaser, thirty (30) days after Dominion's receipt of said notice of revocation. This GUARANTY shall apply to the renewals extensions and modifications of any claims or terms guaranteed by this instrument including extensions of time for payment hereof, and shall not be affected by any surrender or release by Dominion of any other security held by it for any claim hereby guaranteed. This GUARANTY is, and shall remain binding upon the heirs, estate representatives, successors, and assigns of each Guarantor. If Purchaser changes its legal formation or status after execution of this GUARANTY (hereinafter "Successor Entity") with or without the knowledge or consent of Dominion, the applicant hereby shall unconditionally and absolutely, jointly and severally, guarantee the payment of all claims, service charges, costs and attorney's fees assessed or incurred by Dominion for any indebtedness incurred by or transferred to such Successor Entity from Purchaser. This GUARANTY is independent of any rights that Dominion may have with respect to the debt(s) of Purchaser, its successors and assigns, and all of Dominion's rights are cumulative and not alternative.

The applicant hereby waive(s) all privilege of exemptions, including their homestead exemption, as well as all requirements or rights with regard to notice, presentment, demand, notice of dishonor, notice of protest, notice of demand and nonpayment in the event of default, and the applicant further agree(s) that venue and jurisdiction for any legal proceeding to enforce the terms of this GUARANTY, including payment, may be brought at Dominion's option, in the applicable Courts of competent jurisdiction, in and for Montgomery County, Maryland for Maryland Purchasers; and in and for Fairfax County, Virginia, for Virginia Purchasers; this GUARANTY and its terms shall be interpreted and governed by the laws of the State of Maryland.

THE APPLICANT AGREE(S) TO ALL TERMS OF THIS GUARANTY AND THE APPLICANT, RECOGNIZING THAT HIS/HER INDIVIDUAL CREDIT HISTORY MAY BE A NECESSARY FACTOR IN THE EVALUATION OF THIS PERSONAL GUARANTY, HEREBY CONSENT(S) TO AND AUTHORIZE THE USE OF A CONSUMER CREDIT REPORT ON THE APPLICANT BY DOMINION, FROM TIME TO TIME AS MAY BE NEEDED, IN THE CREDIT EVALUATION PROCESS, AND THE APPLICANT AGREE(S) TO HOLD HARMLESS DOMINION, AND ITS EMPLOYEES FOR CREDIT REPORTING OF THE APPLICANT AND AUTHORIZE(S) DOMINION TO DISSEMINATE CREDIT INFORMATION ABOUT THE APPLICANT TO INQUIRING SOURCES.

By clicking Submit, below, I certify that I have read, fully understand and accept all the terms of the foregoing Application Statement, and have read and agree to all the terms and conditions of sale: