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CREDIT APPLICATION FORM

We encourage you to fill out the application for credit terms for our crane rental services. This will simplify your transactions and enable us to meet your needs better.  If you have any questions, or need a copy of an application, please contact our office @ 636-441-4100.

Insurance Certificate
W-9 Federal Form
Safety Guidelines
Hand Signals

Applicant Information Section

Address Info
Business Property
Purchase Orders
Yes
No

Owner Information Section

Banking Information

Trade References

Credit Card Information

Being the cardholder, corporate officer, or authorized purchaser, by signing below I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize to charge my credit card, for the services provided. I further agree that in the event my card becomes invalid, I will provide a new valid credit card upon request, to be charged for outstanding balances.

Applicant Acceptance

The undersigned represents and warrants that all information is true, correct, and complete, and has read, accepted, and agrees to be bound by all terms and conditions as outlined in this document and as detailed in each service agreement ordered by the Applicant or their agent(s). It is further understood and agreed that the Applicant specifically agrees and consents to Missouri Crane, Inc. investigating credit and trade payable histories and using credit reporting services to secure this information. In order to ensure this credit accommodation, the Applicant authorizes the now and future use of consumer credit reports and the full and complete release of credit and account information from the bank references noted in the Application.

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Payments for our invoices are due and payable upon receipt of the invoice. A late payment charge of 1 1/2% per month (an annual percentage of 18%) will be made on any balance more than 30 days after the invoice date. If the amount due is collected by or through an attorney after maturity, the lessee agrees to pay reasonable attorney fees. Notice to Owner: Failure of this contractor to pay those persons supplying material or services to complete this contract can result in the filing of a mechanic's lien on the property which is the subject of this contract under Chapter 429 RSMo. To avoid this result you may ask this contractor for "Lien Waivers" from all persons supplying material or services for the work described in the contract. Failure to secure lien waivers may result in your paying for labor and materials twice.


The Applicant and its Agent(s) agree to indemnify and hold harmless Missouri Crane, Inc. and its agents, officers, and employees from and against any claims, demands, actions, damages, and expenses in conjunction with the loss of life, personal injury, damage to property, debts, and all other claims arising from services, equipment, or merchandise furnished under any rental contract.

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Equal Credit Opportunity Act Notice

We comply with the Equal Credit Opportunity Act (ECOA), which prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to contract), because all or part of the applicant's income derives from any public assistance program, or because the applicant has exercised any right under the Consumer Credit Protection Act.  (www.ftc.gov)

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