Clifford Power Business Account Application

Clifford Power customers have the option to establish a line of credit for their purchases and services. You can fill out and submit the Business Account Application below.

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

CPS Salesperson*

Contract Value

Parent Company Information

Parent Company Name*

Parent Company Address*

Street Address City State ZIP Code

Phone

Billing Portal Information

Do you use a third-party billing portal?*

Yes

Billing Portal Name*

Billing Portal Contact*

Billing Portal URL*

Billing Information

Billing Address*

Street Address City State ZIP Code

Accounts Payable Contact*

AP Contact Email*

Are Purchase Orders Required*

Yes

Sales Tax Information

Sales Tax Status*

Taxable

Exempt

Permit / Certificate Number*

Type*

City*

County*

State*

Upload Exemption Certificate*

Accepted file types: pdf, jpg, png, Max. file size: 5 MB.

Credit References

Please provide three (3) trade references with whom you have an open account. Pre-printed forms are acceptable instead of filling out this section, please attach below.

1. Company Name

Address

Account Number

2. Company Name

Address

Account Number

3. Company Name

Address

Account Number

Upload Pre-Printed Credit References

Accepted file types: pdf, jpg, png, Max. file size: 5 MB.

Customer Authorization & Agreement

Under penalty of perjury, I certify that all information contained herein is correct, complete, and submitted for the purpose of securing credit. If credit is granted, we agree to the terms of net due upon receipt with a service charge of 1.5% per month added to all invoices past 30 days. If invoices remain unpaid after 40 days, this account will be subject to being placed on a C.O.D. basis. The laws of Oklahoma shall govern this account. Should Clifford Power need to file a lawsuit to collect, this account acknowledges and agrees that jurisdiction and venue shall lie in the District Court of Tulsa, County, Oklahoma, and that Oklahoma law shall govern. Applicant agrees to pay any and all collection costs incurred to collect the amount owing, including, but not limited to, reasonable collection agency fees, attorney fees and court costs.

Signature*

Name*

Title*

Company Information

Parent Company Information

Billing Portal Information

Billing Information

Sales Tax Information

Credit References

Customer Authorization & Agreement

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