PLEASE COMPLETE & MAIL TO: Attn: Credit Dept.

BCT Ohio3406 Fortuna DriveAkron, Ohio 44312

(330) 896-9712 or FAX (330) 896-9721Wholesales Printers to the Trade

DEALER APPLICATION & PAYMENT AGREEMENTDEALER INFORMATION:

Company Name Company Contact

MAIL TO Street or P.O. Box Address Owner Description of Business

City, State, Zip Type of Ownership Date Founded

SHIP TO Street Address Telephone Fax E-mail

City, State, Zip Average Annual Sales Credit Limit Requested

I authorize BCT Ohio to keepmy signature on file and tocharge my credit card accountas indicated.Check One:

❏ MasterCard❏ VISA❏ American Express

Company Name Cardholder Name

Cardholder Billing Address City, State, Zip

Account Number Expiration Date

Cardholder Signature Date

ACCOUNT INFORMATION FOR CREDIT CARD PAYMENT:

BLANKET CERTIFICATE OF EXEMPTION:

The undersigned hereby claims exemption to purchases of tangible personal property from Akron Thermography,Inc. dba BCT® Ohio, on or after __________________,20_____, and certifies that this claim is based upon thepurchaser’s proposed use of the items purchased, the activity of the purchaser, or both, as shown below:

“For resale in the form in which the same is, or is to be received.”

Purchaser’s Name Purchaser’s Activity

Purchaser’s Street Address City, State, Zip

By: (Signature) Title Date Signed Vendor’s License No.

THIS CERTIFICATE SHALL CONTINUE IN FORCE UNTIL REVOKED IN WRITING AND SHALL BE CONSIDERED APART OF EACH ORDER GIVEN TO THE ABOVE NAMED VENDOR UNLESS THE ORDER SPECIFIES OTHERWISE.

❏Corporation ❏Proprietorship or Partnership EIN _______________ SSN _________________

Ohio

CREDIT APPLICATION & PAYMENT AGREEMENT

TRADE REFERENCE: (Please use references that you have a credit account with)

Company Name Telephone Fax Purchased from since

Street Address City, State, Zip

Company Name Telephone Fax Purchased from since

Street Address City, State, Zip

Company Name Telephone Fax Purchased from since

Street Address City, State, Zip

PRIMARY BANK REFERENCE:

1

2

3

Bank Name Branch Telephone Number

Street Address City, State, Zip

Name of Bank Employee Contact Title Account Numbers

CREDIT TERMS OF PAYMENT:

Akron Thermography, Inc. dba BCT® Akron (hereinafter BCT® Akron), reserves the right to assign credit terms toits Dealers based on information learned from credit applications submitted and credit references furnished, aswell as from actual Dealer payment experience.

By submission of this Agreement, the Dealer identified above has applied for credit terms which may be either“Net 7 Day” or “Net 30 Day”. If approved and assigned “Net 7 Day” terms, payment in full for each invoice isdue no later than 7 days after the date of the invoice. If approved and assigned “Net 30 Day” terms, payment infull for each invoice is due no later than the 30 days after the date of the invoice.

If for any reason, the applicant is unable to pay BCT® Akron, in accordance with the assigned terms, applicantagrees to contact BCT® Akron immediately. Credit may be suspended or modified at any time should the Dealerfail to adhere to the approved payment terms.

In the event of default on these terms the applicant shall bear all collection fees, legal fees, and court costsassociated with such default. BCT® Akron reserves the right to charge, and applicant agrees to pay interest in theamount of one and one-half percent (1½%) per month on all past due invoice amounts.

A Twenty-five dollar ($25) service charge shall be paid by the applicant to BCT® Akron for each check returnedby the bank for insufficient funds or for any other reason. In addition BCT® Akron reserves the right to pursuecollection of monies represented by such bad checks to the fullest extent of the law.

The applicant hereby gives permission to disclose its experience with the bank indicated above to BCT® Akron.This information is to be used in consideration of granting an open account to the applicant.

I acknowledge that I have read the above terms and condition of credit and agree to adhere to them.Authorized Signature Date Printed Name & Title

BCT® Akron Office Use - Date & InitialApp. Rec’d Inq. Mailed Bank Inq. Mailed Trade Ref #1

Rec’dTrade Ref #2

Rec’dTrade Ref #3

Rec’dApplicantNotified

Terms Assigned