814-456-7574
Home
About
Our Company
Meet the Team
Blog
Products
Hose, Tubing, and Fittings
Valves and Accessories
Gaskets and Packing
Piping Accessories
Line Card
FAQs
Credit Application Request
Contact
Site Menu
Home
About
Products
Line Card
FAQs
Credit Application Request
Contact

Form

Credit Application Request

Download PDF

Credit Application

Company Name *
AP Contact Person *
Corporate Structure *
Company Phone *
Fax Number
Email Address for Invoices *
Website URL *
Billing Address *
Shipping Address *
Year Established *
Federal EIN *
Type of Business *
Taxable?
*If no, please attach Exemption Certificate.*
Exemption Certificate

Bank Reference

Bank Name *
Address *
Accounts *
Bank Phone *

Trade References

Company Name #1 *
Address #1 *
Phone Number #1 *
Company Name #2 *
Address #2 *
Phone Number #2 *
Company Name #3 *
Address #3 *
Phone Number #3 *
quote

The Sullivan team responds quickly to our needs and is a pleasure to work with.

Jim Noe, Manager, Production Maintenance
Lord Corporation
Erie, PA
1433 East 10th Street
Erie Pennsylvania 16503
2024 © Sullivan Supply Company
Terms & Conditions | Powered By Epic Web Studios