City Express Commercial Credit Application

City Express Delivery Service account holders enjoy priority service, fast and painfree ordering, and customized billing.

Complete the form below to establish an account using a charge card (i.e., either a credit or debit card). We will still send you a weekly invoice, but the invoice will reflect a zero balance with a single charge card line item.

Complete the application below to apply for a credit line with City Express for its services. The application requires a fair amount of information, and we recommend that you first print out this page and gather the information necessary to complete the credit application.

(As an alternative to completing the credit application below, you may establish an account for City Express services simply by providing a charge card using this shorter form, here.)

* Optional fields
Promotion Code
(if available)*:

 
Account Name:
   
Organization Name
(if different)*:
   
Primary Contact:
   
Last Name:
   
First Name:
   
Middle Initial*:
   
Phone:
 (Include area code)
   
Fax*: (Include area code)
   
Online Access:
  
   
E-mail Address:
 (to be used as your User ID)
   
Desired Online Password:
 (No spaces; 10 character limit)
   
Confirm Password:
   
Address:
  
   
Street 1:
   
Street 2*:
   
City:
   
State:
   
ZIP Code
   
Billing Address: Same as above
  
   
Street 1:
   
Street 2*:
   
City:
   
State:
   
ZIP Code
   
   
Accounts Payable Manager:
  
   
Last Name:
   
First Name:
   
Middle Initial*:
   
Title:
   
E-mail Address*:
   
Phone:
 (Include area code)
   
Fax:
 (Include area code)
   
Organization Overview:
  
   
Business Description:
   
Form of Entity:
   
Number of Employees:
   
State of Incorporation:
   
Year Established:
   
Registered Agent:
  
   
Registered Agent Name:
   
Street 1:
   
Street 2:
   
City:
   
State:
   
Zip Code:
   
Bank Information:
  
   
Bank Name:
   
Branch Location:
   
Bank Account Number:
   
Contact Name:
   
Contact Phone:
 (Include area code)
   
First Trade Reference:
  
   
Company Name:
   
Account Number:
   
Contact Name:
   
Contact Phone:
 (Include area code)
   
Street 1:
   
Street 2*:
   
City:
   
State:
   
Zip Code:
   
Second Trade Reference:
  
   
Company Name:
   
Account Number:
   
Contact Name:
   
Contact Phone: (Include area code)
   
Street 1:
   
Street 2*:
   
City:
   
State:
   
Zip Code:
   
Third Trade Reference:  
   
Company Name:
   
Account Number:
   
Contact Name:
   
Contact Phone: (Include area code)
   
Street 1:
   
Street 2*:
   
City:
   
State:
   
Zip Code:
   
Name of Authorized Agent for Applicant:
   
I, as Authorized Agent for Applicant, understand that this information is given with the understanding that it will be held in the strictest of confidence. I understand that this information will be used by City Express® to facilitate the opening of a charge account for the above named entity. I understand that all individual services performed by CE result in charges that are due upon completion of the individual services, and, if not paid sooner and by other means, CE is authorized to collect payment for the services by automatically charging the charge card provided on a weekly, or other periodic basis, for services that remain unpaid at that time. If this balance is declined from the charge card, and the invoices are not paid otherwise, and if this matter must be placed in the hands of an attorney, the applicant agrees to pay all costs incurred in the collection of the debt, including reasonable attorneys' fees.
I agree to these terms of service. Enter Initials
I decline.
 
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