Credit Application.qxp - Dynalab Corp.

Credit ApplicationCompany Name:Dynalab Corp.350 Commerce DriveRochester, NY 14623 USATel 585-334-2060 800-828-6595Fax 585-334-0241www.dynalabcorp.com__________________________________________________________________________________Bill to Address:______________________________________________________________________________________________________________________________County ____________________________________Ship to Address:____________________________________________________________________________________________________________________________________County ______________________________________Phone #: __________________________________ Tax ID#: ______________________________________Fax #: ______________________________________Duns #: ______________________________________Acc’ts Payable Contact: ____________________ Purchasing Contact: __________________________Contact E-mail: ____________________________ Contact E-mail: ______________________________Customer Taxable Yes No (Please Provide Tax Exempt Form)NOTE: Please see page 2 for trade and bank reference information.TERMS: Terms are net 30 days.In the event that terms are not metthere will be an additional 1.5%added to your invoice for late charges.RETURNS: Returns will not be acceptedwithout a Return Goods Authorization Number(RGA#). See terms and conditions page forfurther information.The above information as well as that given on the second page is for the purpose of obtaining credit and is warrantedto be true. I/We hereby authorize the firm to whom this application is made to investigate the references listed pertainingto my/our credit and financial responsibility.Signature : __________________________ Date: __________________________________Dynalab Corp. does not guarantee the approval of your credit application. Should you bedenied, an account representative will contact you with alternate payment options.Office Use OnlyOrder Value $ __________________________________ Sales: __________________________Date: ____________Price Book: _____ LABTrade References Attached________________________Non-taxable Certificate Attached:__________________Accounting ______________________Date: ____________D & B Results Attached: __________________________Suggested Credit Limit: $ ________________________President:________________________Date ____________Actual Credit Limit Granted: $ ____________________Dynalab Trade Discount __________________________ Authorized By: __________________Date ____________cpl1008KD PAGE 1

Dynalab Corp.350 Commerce DriveRochester, NY 14623 USATel 585-334-2060 800-828-6595Fax 585-334-0241www.dynalabcorp.comCompany Name:__________________________________________________________________________Trade References:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Contact: ______________________________ Contact: ________________________________Bank References:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Contact: ______________________________ Account #: ______________________________Contact: ________________________________*Please note:If you are planning on paying by credit card please disregard page 2 and continue on to page 3.REMIT TO ADDRESS:Dynalab Corp. 350 Commerce Drive Rochester, NY 14623cpl1209KD PAGE 2

DYNALAB ® TERMS & CONDITIONS EFFECTIVE JANUARY 1, 2011FREIGHT:All orders are F.O.B. factory, Rochester, NY. All shipments will berouted via surface transportation unless premium methods arerequested.DISCOUNTS:Standard stock items purchased at suggested list will receive a 10%discount on orders of $250 or more.CREDITS & RETURNS:All large quantity returns are subject to review and refusal byDynalab. We will not accept returns without prior authorization(RGA number must appear on outside of carton and on all paperworkinvolved) as well as reference to original Purchase Order.Merchandise held beyond twelve (12) months, specially fabricatedor modified merchandise, specially labeled items, partial brokencases or discontinued items CANNOT be returned for credit.Accepted returns will be credited less restocking charge (15% fororders received within 0 to 6 months and 25% for orders receivedwithin 6 to 12 months) and must be returned freight prepaid.No credit will be issued until the returned goods have beenreceived by Dynalab and are verified to be the goods stated andin re-salable condition. Dynalab requests that any goods shippedback to Dynalab due to an error at Dynalab - such as incorrectitem shipped, be shipped back to Dynalon on our collect UPSaccount, ground method to minimize freight charges onreturned good. Contact customer service for this information.A Credit Memo (CM) will be issued at this time and faxed as confirmationof receipt and verification that the goods were in satisfactorycondition. In case of our error, full credit will be issuedupon receipt of the incorrect item. Credits that arise from billingerrors will also be verified by sending the customer a CM.Customers will not be allowed to take "debits" prior to thereceipt of the CM and the CM number must be referenced whentaking the debit.DAMAGE:It is the responsibility of the purchaser to notify delivery carriers inthe event of receipt of goods that are in damaged condition. If thedamage is not caused by shipping, claims must be made to Dynalabwithin ten (10) days of receipt of the merchandise.WARRANTIES:Dynalab only warrants that products supplied by Dynalab under normaluse and application are free from defects in material and workmanshipand will conform with Dynalab specifications under observanceof chemical, physical and biological properties. All other warranties,express or implied, including warranties of merchantabilityand fitness for a particular purpose are excluded and disclaimed.Dynalab's warranty for any product is void and of no effect, if suchproducts or parts thereof have been subject to abuse, misuse, accident,alteration, unauthorized repair or other use not in conformitywith intended purpose.EXCLUSIVE REMEDY AND LIMITED DAMAGES:Purchaser’s sole remedy against Dynalab for any damage, loss orinjury resulting from purchaser’s order, including any defect in anyDynalab product, shall be limited to a refund of the purchase priceor replacement of the product. All damaged products must bereturned to Dynalab, freight prepaid, in accordance with Dynalabwritten instructions. In no event shall Dynalab be liable to the purchaseror any other person for any indirect, special or consequentialdamages or lost profits.DROP SHIPMENTS:Drop shipments will be made on an occasional basis at no extracharge to the purchaser.PRICES:All prices and specifications are subject to change without notice.VOLUME DISCOUNTS:Additional volume discounts may be available on large purchases ofone product, call, fax or write Dynalab for quotation.DISCONTINUED ITEMS:Dynalab will use its best efforts not to discontinue items during thelife of its catalog. However, on occasion this will have to occur.Whenever possible, Dynalab will notify its purchasers in advance ofthe discontinuation of a product.Copyright Dynalab Corp. 2011 and earlier.Signature denotes acceptance of above terms: ________________________________________________Printed Name:____________________________________Date __________________________________cpl1008KD PAGE 3