Flatbeds – DND

Name(Required)

First Last

Email(Required)

Phone(Required)

Are you looking to lease, purchase or lease to purchase?(Required)

Lease

Purchase

Lease to purchase

What date is the equipment needed?(Required)

Owner or Company Officer

Name(Required)

First Last

Title(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Phone(Required)

Secondary Phone

Social Security #(Required)

Driver's License #(Required)

Driver's License State(Required)

DOB(Required)

Owner's Driver's License(Required)

Please upload a copy of the owner's driver's license.

Max. file size: 128 MB.

Previously filed for bankruptcy?(Required)

Yes

No

Date of Bankruptcy Filing

Type

Trade References

Must include vendors used by your company

Vendor Name(Required)

Contact Name(Required)

Phone(Required)

Vendor Name

Contact Name

Phone

Vendor Name

Contact Name

Phone

Banking Information

Bank Name(Required)

Phone(Required)

Account Number(Required)

Bank Name

Phone

Account Number

Bank Name

Phone

Account Number

Attach last 3 months of bank statements(Required)

Max. file size: 128 MB.

Insurance Information

Insurer Company Name(Required)

Agent Name(Required)

Phone(Required)

Proof of Insurance Certificate(Required)

Max. file size: 128 MB.

I hereby authorize DND International, Inc. to obtain a report from any credit reporting agency or from any other source(s) pertaining to the company’s credit history. I also authorize DND International, Inc. to obtain a personal credit report from any reporting agency or any other source pertaining to personal credit history. I also authorize drivers and employees to sign for the company when picking up trailers, parts, or repairs, and I authorize that DND International, Inc. can keep copies of my company information on file for use at a later date. Customer is responsible for any attorney’s fees and court costs in case of suit. I further authorize DND International, Inc. to use the EFS system ACH withdrawal on any check issued to DND International, Inc. to process any payments. I agree to the above terms and attest the information to be true and correct, to the best of my knowledge.

Signature(Required)

Type your full name to accept the terms above

Title(Required)

Date(Required)

How did you hear about DND International, Inc.?

If you have previously spoken to a DND International, Inc. sales representative, please let us know:

Unconditional Guaranty of Payment and Performance

The UNDERSIGNED(S) ("GUARANTOR"), as consideration for the present of future extension of credit by DND INTERNATIONAL, INC. to UNDERSIGNED(S) ("CUSTOMER"), does hereby unconditionally guarantee the prompt payment and performance of all obligations owed by CUSTOMER to DND INTERNATIONAL, INC. GUARANTOR hereby expressly acknowledges that there are no conditions precedent to the effectiveness of enforcement of the Guaranty and that GUARANTOR is jointly and severally liable along with CUSTOMER to DND INTERNATIONAL, INC. by virtue of the terms hereof as primary obligors and debtors.

Customer Name(Required)

Phone(Required)

Customer Social Security # or FEIN #(Required)

Customer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

GUARANTOR SIGNATURE(Required)

By filling out the field below you agree as the GUARANTOR to the Guaranty statement above

Date(Required)

Guarantor Name(Required)

First Last

Phone(Required)

Guarantor Social Security #(Required)

Guarantor Driver's License #(Required)

Driver's License State(Required)

Guarantor Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please attach a copy of Guarantor's Driver's License(Required)

Max. file size: 128 MB.

Tires & Brakes Policy

Our charge for tire usage is per 1/32" of a tire tread and per 1/8" for brakes. (See page 10 of lease agreement.) If lessee doesn’t want to pay these charges, they can change tires by themselves and bring the trailers back with similar tire tread as when they picked up. We accept only virgin trailer tires of reputable American brands, Double Coin or Roadmaster tires from China, or Kumho tires from Korea. No recap, regroove, drive or steer tires will be accepted. IMPORTANT: Returned flatbed trailers will only be accepted with flatbed tires, not van- or reefer-style tires. NOTE: To prolong tire life, always check tire pressure and keep it between 95–100 psi.

Lessee(Required)

By(Required)

Title(Required)

Signature(Required)

By entering your full name below you agree to the tires and brakes policy above.

Date(Required)

ACH Authorization

DND INTERNATIONAL, INC. is hereby authorized to initiate EFT/ACH entries to the Company and Account at the Financial Institution indicated below. The Financial Institution has been notified that this account will be subject to EFT transactions. If your account is approved requiring ACH payments: Your rental invoices will be paid automatically as an electronic payment directly from your bank account. Please remember that your payment is due at the time of the rental cycle billing. With this direct payment pro- gram, the day that the funds are drawn varies each month, based on the rental cycle. You will need to have the amount of the monthly lease charge in your account on the day that we post the charge to the bank account that you provided to us. DND INTERNATIONAL, INC. will start this service as once a rental unit has been released to your company. Please know that the following policies will apply: · Automatic payments are for lease (and related) charges only. This includes mileage, net/net charges, reefer hours charges, damages, etc.; per your lease agreement. Other charges, such as purchases at our parts counter, other service and shop charges, etc., must be paid with a separate check, cash, or credit card at the time of purchase. · Our policy regarding NSF payments (non-sufficient funds) will be in effect. If you have a NSF payment or dishonored payment, you will owe a $50.00 NSF fee and you may be required to return unit/s on rent. · You must notify DND INTERNATIONAL, INC. if you change the bank that you have the automatic withdrawal on. · A receipt will be mailed to you once the payment has been posted.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Name(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Title of Account(Required)

Financial Institution(Required)

Financial Institution Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ABA/Routing Number(Required)

Account Number(Required)

Bank Contact(Required)

First Last

Bank Phone(Required)

Voided Check(Required)

Please complete the attached authorization form and return it to us with a copy of a voided check so we have the correct routing and account information. If you do not have a voided check, your bank will be able to provide you in writing the correct bank information to attach to the authorization form. Please do not attach a deposit slip, as it may not contain the correct information that we need.

Max. file size: 128 MB.

Authorization & Policy Agreement

Authorized Representative(Required)

First Last

Authorized Representative's Title(Required)

Authorized Representative's Signature(Required)

By entering your name below you agree to the authorization and policy statement above.

Company Information

Owner or Company Officer

Trade References

Banking Information

Insurance Information

Unconditional Guaranty of Payment and Performance

Tires & Brakes Policy

ACH Authorization

Authorization & Policy Agreement