*  Name of Company:
*  Contact Name:
*  Email Address:
Address of Headquarters:
Address Line 2:

City:	State:    Zip Code:
Billing Address:
Billing Address 2:
City:	State:    Zip Code:
Local Phone Number:	Fax:
Dun and Bradstret Number:
Type (s) of Business Services D. M. Bowman, Inc. is to provide: (check all that apply)
	Trucking / Transportation
	Building / Rental
	Warehousing
	Land Rental
	Maintenance
	Retail Fuel
*  Amount of credit requested:	$
	Volume of Business Expected (Loads per dollar volume per week, per month, per year):
	Special Billing Requirements:

If D. M. Bowman, Inc. accepts this request for credit, I or we acknowledge and agree to the following: (1) Payment is jointly, severally and unconditionally guaranteed within 30 days of invoice date; (2) any charges unpaid after the above 30 days are to be increased by 1.5% per month; (3) any charges still outstanding after 90 days from the date of delivery are subject to collection, and all collection or arbitration expenses, attorney's fees, and court costs will be borne by the purchaser; (4) all claims, requests for adjustments, or notification of errors must be made within thirty days of the date of invoice, or charges are considered accepted; (5) this agreement shall apply to all current and future charges unless revocation is received by registered mail prior to the delivery services; (6) credit privileges may be withdrawn at any time without invalidating the terms of this agreement. Any disputes pursuant to the agreement shall be resolved in Federal or State Court (s) located in Maryland and in accordance with the laws of that jurisdiction. Purchaser hereby consents to the jurisdiction of the State and/or Federal Courts located in Maryland and waives any objections to venue on the basis of non-convenient forum or any other reason.

*    I agree to the above terms.

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