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Payment by Check RDS Delivery

* Required Field

Company Name: *
Company Address: *
Room/Floor #:
City: *
State: *
Zip: *
Phone: *
Fax #:
E-mail address: *

 
If your billing address or email is different from your general correspondence:
A/P Contact:
A/P Address:
Room/Floor #:
City:
State:
Zip:

Phone:
Fax #:
E-mail address:
 
Type of Business: *
Years Established: *
How would you like to receive your invoices ? *




          

How would you like to receive proof of delivery ? *




          
How much are your average monthly courier bills ? *

 

Business Associates/References

 

1. Company: *
Contact Name: *
Address: *
City: *
State: *
Phone: *
2. Company: *
Contact Name: *
Address: *
City: *
State: *
Phone: *
3. Company:
Contact Name:
Address:
City:
State:
Phone:

 

Bank Reference

 

Bank Name: *
Acct # *
Branch Address: *
Branch City/State/Zip: *
Phone #:
Contact Person:

 

Credit Card Authorization

 

Please provide a credit card number to establish credit. Invoices that remain open in excess of 40 days may be charged

 

Cardholder’s Name:
Address:
City:
State:
Zip:
Card Type
Card # Exp.
Note: If you wish to receive emails from RDS regarding your statements and proof of delivery, please remember to add our email address to your Safe Sender list in your email program so that important emails such as these don’t risk being blocked as spam.

 

In opening this account, please be advised that RDS Delivery Service Co., Inc., does not take responsibility for cash, jewelry, furs, fine art or securities. RDS Delivery Service limits its liability to maximum of $100.00 per delivery unless otherwise negotiated in writing. In consideration for credit being extended by RDS, I acknowledge and agree to the following: (1) Payment for all work performed by RDS Delivery Service is personally, jointly, severally, and unconditionally guaranteed within 15 days of billing; (2) any charges outstanding after 40 days can be charged on the credit card indicated above; (3) any charges outstanding after 60 days from date of billing are subject to collection, and all collection or arbitration expenses, attorney fees, and court costs will be borne by the purchaser; (4) all claims, requests for adjustments, or notification of errors must be made within thirty days; or charges are considered accepted; (5) RDS Delivery Service Co., Inc assumes no responsibility for the condition of the item being shipped; (6) this agreement shall apply to all current and future charges unless revocation is registered mail;(7) releases RDS Delivery Service Co., Inc., its employees and or agents from liability and responsibility for the condition of the items throughout the receipt and delivery process (8) represents to RDS Delivery Service Co., Inc. that the contents of the shipment is not hazardous or illegal in nature.(9) all work is subject to the Terms and Conditions above. My name below is confirmation that I have read and understand this agreement.

 

Authorized Virtual Signature *

 




   

This is great! Fast and easy. Thank you for walking us through the steps.

Rosemary Harris,
NYU Medical Center

RDS Delivery Service      436 East 11th St.   New York, NY 10009 USA     Phone: 212-260-5800     Email:     Fax: 212-260-1090
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