Contractor's Discount Application

Please print this page and fax to (804) 739-2939 for approval

(To qualify for contractors discount $1500.00 worth of purchases is required per calendar year,
 these discounts will be reviewed and we reserve the right to suspend your contractors discount 
and adjust invoices to regular rates should requirements not be met)

Date: 

Company Name: 

Address: 

City:     State:     Zip: 

Business Phone:    Fax: 

What type of business: 

Business License #:    Year Established: 

Federal ID # or Social Security #: 

Tax exempt # (if applicable): 
(please attach copy of tax exempt form)

Authorized buyers to sign on account: 

I hereby certify that all information given above is accurate to the best of my knowledge.

Print Authorizing Name Title
Signature of Authorizing Name Telephone Number

Yard Works LLC is not responsible for damages incurred to driveways, property, etc. once delivery truck leaves the state maintained road.  The customer, hereby, agrees to pay for all wrecker fees, and to accept responsibility for damages to property and or vehicles.

Office use only: _______  Approved by:  ____________________  Date:  ____________