CREDIT APPLICATION | SALES REP HANS AAN DE STEGGE


GOT QUESTIONS? CALL US AT (949) 788-0900 EXT 221, 220 & 207

FAX (714) 862-1008 | EMAIL: CREDITAPP@PROVENZAFLOORS.COM

SALES REPRESENTATIVE: HANS AAN DE STEGGE  |  SALES REP ID: ADS00001

Please fill out the credit application completely.  Any missing or incomplete fields may lead to a delay in processing the credit application.

Business Data

     

     

   

PLEASE CHECK ONE. WHAT ARE YOU APPLYING FOR:

PLEASE CHECK ONE. COMPANY IS A:

 

     

   

OWNER(S) | PRINCIPLE(S)

 

   

 

 

   

BUSINESS AND CREDIT INFORMATION

 

 

 

TRADE REFERENCE (PLEASE FILL OUT THREE REFERENCES.)

 

 

 

 

 

 

 

 

 

 

AGREEMENT

The company hereby authorized the above banks to release all information requested. It is understood that all information will be kept confidential.

The representations provided in this Application are complete and accurate. I understand the information provided will be relied upon the evaluation and extension of credit terms. I authorize the release of information by creditors listed above as well as other suppliers. The terms and condition of this Application shall, upon extension of credit by the Company, constitute an agreement of sale. The Application agrees to be bound to the terms stated on the Company’s invoice. The failure to pay on the due date of each invoice shall deem the debt to be delinquency; all collection expenses and attorney’s fees in connection with the collection of the delinquent debt shall be due and payable by the Applicant. The interpretation of this agreement shall be subject to the laws of the State of California, and any necessary legal action shall be brought in Orange County, CA.

(Arbitration Clause)

The company and the Applicant agree that any claim or dispute between or among them, their agents, employees, successors or assigns, related to this Application, the credit extended thereafter or otherwise (other than the exercise of rights under security interests created by purchase or otherwise), including disputes related to the applicability of this Agreement, regardless against whom made, shall be resolved by binding arbitration by and under either (a) the Code of Procedure of the National Arbitration Forum or (b) American Arbitration Association. This Agreement shall be subject to and interpreted under the Federal Arbitration Act.

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Signature Certificate
Document name: CREDIT APPLICATION | SALES REP HANS AAN DE STEGGE
lock iconUnique Document ID: bb0a98bf3aff695a427ca78b913d022502023aac
Timestamp Audit
October 2, 2020 6:18 pm PDTCREDIT APPLICATION | SALES REP HANS AAN DE STEGGE Uploaded by Provenza Floors - SecureSign@ProvenzaFloors.com IP 12.107.23.226
October 2, 2020 6:22 pm PDTJanie Santiago - assessment1@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 2, 2020 6:22 pm PDTTania Hernandez - assessment6@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 2, 2020 6:22 pm PDTJack Carroll - credit@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 2, 2020 6:22 pm PDTSharum Vosough - Sharum@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 9, 2020 1:01 pm PDTJanie Santiago - assessment1@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 9, 2020 1:01 pm PDTTania Hernandez - assessment6@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 9, 2020 1:01 pm PDTJack Carroll - credit@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
October 9, 2020 1:01 pm PDTSharum Vosough - Sharum@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 64.60.97.55
May 6, 2021 3:24 pm PDTJanie Santiago - assessment1@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 91.196.220.159
May 6, 2021 3:24 pm PDTTania Hernandez - assessment6@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 91.196.220.159
May 6, 2021 3:24 pm PDTJack Carroll - credit@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 91.196.220.159
May 6, 2021 3:24 pm PDTSharum Vosough - Sharum@provenzafloors.com added by David Janti - David@ProvenzaFloors.com as a CC'd Recipient Ip: 91.196.220.159
October 31, 2022 9:54 am PDTJanie Santiago - assessment1@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.135.136.144
October 31, 2022 9:54 am PDTTania Hernandez - assessment6@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.135.136.144
October 31, 2022 9:54 am PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.135.136.144
July 31, 2023 4:48 pm PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 5.182.16.168
July 31, 2023 4:48 pm PDTTania Hernandez - assessment6@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 5.182.16.168
July 31, 2023 4:48 pm PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 5.182.16.168
October 9, 2023 11:15 am PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.244.249.154
October 9, 2023 11:15 am PDTRo Hassanein - rodaina@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.244.249.154
October 9, 2023 11:15 am PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.244.249.154
April 21, 2025 1:40 pm PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.202.221.54
April 21, 2025 1:40 pm PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.202.221.54
April 21, 2025 1:40 pm PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.202.221.54
April 21, 2025 1:40 pm PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 185.202.221.54
March 10, 2026 3:08 pm PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:08 pm PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:08 pm PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:08 pm PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:10 pm PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:10 pm PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:10 pm PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 10, 2026 3:10 pm PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 16, 2026 10:15 am PDTJanie Santiago - Janie@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 16, 2026 10:15 am PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 16, 2026 10:15 am PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
March 16, 2026 10:15 am PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:40 pm PDTJack Carroll - credit@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:40 pm PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:40 pm PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:40 pm PDTElias Aldana - elias@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:42 pm PDTAssessment Two - assessment2@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:42 pm PDTAssessment Three - assessment3@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
August 17, 2026 3:42 pm PDTElias Aldana - elias@provenzafloors.com added by Provenza Floors - SecureSign@ProvenzaFloors.com as a CC'd Recipient Ip: 12.107.23.226
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