Phone number:

Please use XXX-XXX-XXXX

After Hours Number:

Please use XXX-XXX-XXXX

Fax Number:

Please use XXX-XXX-XXXX

Email Address:


Address:


Suite No.:

City:

State:


Zip Code:


Check if the billing address is the same as address above: (If no please fill address in box below)
Yes
No

Billing Address:
 Form of Company:


Has company declared bankruptcy in the past 5 years?
Yes
No

Authorized Caller(1)
Name:
Email:

Authorized Caller(2)
Name:
Email:

Authorized Caller(3)
Name:
Email:

Individual in charge of accounts payable:


Individual's Email:


Authorized Individual filling out form:


Will your company be using purchase order #'s or reference #'s on each order?:
Yes
No

If needed, are company credit references available?:
Yes
No

By completing this registration process and clicking "I accept" below, you agree to abide by these Terms of Service:

Interstate Express Couriers, Inc. requests the preceding information with the understanding that it will be held in strict confidence. Pending credit approval, your account will be billed bi-weekly with the closing date being the 15th and the last day of the month. Payment is due upon receipt of invoice. A service charge of 1.5% per month will be added to accounts with a past due balance of over 15 days. This contract is made in and shall be governed by the laws of the State of Maryland. If the invoice is not paid within 30 days after its date, Customer shall pay Interstate Express’ costs and legal fees incurred in collecting charges due from Customer whether or not suit is filed. Venue for any legal action shall be in Montgomery County, Maryland. I fully understand that Interstate Express will not be responsible for any claim in excess of $50 per package, INCLUDING BUT NOT LIMITED TO the result of loss, damage, delay, non-delivery, misdelivery, or misinformation, unless a higher value is declared in writing and an additional charge is paid. Your right to recover from Interstate Express for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorneys fees, costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $50 dollars or the declared value agreed upon in writing.


I have read the Terms of Service and I accept

Hands