NEW Customer Application

Individual Proprietors, Partners, Members or Corporate Officers

Accounts Payable Contact Information

About Your Business

Banking Information

Business References, preferably food service suppliers

TERMS AND CONDITIONS 

I/We herein make application to Custom Food Service for credit and/or to update and reaffirm our existing account and balance with Custom Food Service. THE UNDERSIGNED INDIVIDUAL WHO IS EITHER A PRINCIPAL OF THE CREDIT APPLICANT OR A SOLE PROPRIETOR, RECOGNIZES THAT HIS OR HER INDIVIDUAL CREDIT HISTORY MAY BE A FACTOR IN THE EVALUATION, AND HEREBY CONSENTS TO AND AUTHORIZES THE USE OF A CONSUMER CREDIT REPORT ON THE UNDERSIGNED BY THE ABOVE-NAMED BUSINESS CREDIT GRANTOR, FROM TIME TO TIME, AS MAY BE NEEDED IN THE CREDIT EVALUATION PROCESS. If credit is granted, we promise to pay all bills when due. To secure payment for all purchases from Custom Food Service, now and in the future, Debtor hereby grants Custom Food Service a continuing interest in all of Debtor's presently owned or hereafter goods, instruments, Chattel paper, books and records, accounts, accounts receivable, general intangibles, and payment intangibles and together with all proceeds and all support obligations thereof. The following constitute customer defaults: non-payment in timely fashion of customer’s indebtedness to Custom Food Service, bankruptcy, insolvency, or assignment for the benefit of creditors, misrepresentation in respect of any provision of this or any Agreement with Custom Food Service. In the event of default, Custom Food Service may declare all unpaid balances due. Custom Food Service reserves the right to deny credit privileges. The liability for payment of amounts invoiced to the above accounts shall continue regardless of transfer of any interest in or managerial responsibility for the Customer’s business until Custom Food Service is notified in writing of such transfer or sale by certified mail. In the event payment is not made and this account is referred for collection, we agree to pay all costs of collection. If legal action is required, we promise to pay reasonable attorney fees in said suit or action. Applicant also agrees to pay interest and finance charges at the highest rate allowed by law. Applicants give their permission to Custom Food Service and/or its agents to verify, modify or supplement the information stated herein.

PERSONAL GUARANTEE

The undersigned agrees to unconditionally guarantee payment of all sums owed pursuant to the Agreement, including any court ordered damages, and further agrees to its terms regarding venue. This is intended to be and is a continuing guarantee and shall not be revoked except by written notice to creditor by certified mail return receipt. In the event of a sale or transfer of the customer’s business, unless revoked in the manner described above, the personal guarantee herein shall not terminate. The revocation will be recognized as of the date of receipt by the credit grantor. Use of a corporate or any other title shall in no way limit the personal guarantee or liability of the guarantee signatory.

The Guarantor’s signature below with no spousal signature constitutes a warranty and a representation that the guarantor is unmarried, and an acknowledgement that Custom Food Service is relying upon that representation in issuing credit to the customer. Any business entity designation following the signature in this guarantee section, not withstanding. It is understood by the undersigned that signature constitutes a personal guarantee of the account(s) designated on this agreement. This guarantee shall remain in effect regardless of any amendment to this agreement (application) including the credit terms.

CUSTOMER AUTHORIZATION AGREEMENT FOR ACH DEBIT PAYMENTS

indicated below at the depository financial institute named below. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.

This authorization is to remain in full force and effect until Custom Food Service has received written notification from me of its termination in such time and in such manner to afford Custom Food Service and the depository financial institution a reasonable opportunity to act on it.

DINING ALLIANCE

MANUFACTURER APPRECIATION PROGRAM (MAP) LETTER OF PARTICIPATION FORM

*THIS FORM MUST BE FILLED OUT COMPLETELY FOR PARTICIPATION*

PLEASE NOTE: Your first MAP check may arrive up to 9 months after we begin to receive purchasing data, and then quarterly thereafter if minimum

purchasing requirements are met. If minimum requirements are not met, checks will arrive annually.

MULTI-UNITS: Location Information: Locations can be listed on attached sheet. Include Location Name, Address, Account Number, and Distribution House/Division. Excel Spreadsheet preferred.

GPO AFFILIATION

I am not aware of any other GPO food and beverage contracting relationships that are currently in effect. If any other affiliation is in place that I am not aware of, then those relationships are hereby terminated.

List current Affiliation below. Participation in more than one Group Purchasing Organization is strictly prohibited and will disqualify application if other Affiliation has not been terminated prior to engaging Dining Alliance Inc. 

DIRECT MANUFACTURER AGREEMENTS

If your distributor(s) or you directly have contracts with manufacturers directly and desire to remain on those programs directly, you must list those in the space below in order to assure those manufacturers of your intention to remain a direct contracted party for those programs. Failure to disclose this information will acknowledge that you agree to participate in the Dining Alliance Inc. programs with All Manufacturers not disclosed. You also agree to update Dining Alliance Inc. of any additions or deletions to the programs listed below.

You will be required to provide Dining Alliance a copy of the termination letter to each affiliate listed above in order to establish manufacturer program affiliation through Dining Alliance.

ACKNOWLEDGEMENT AND AUTHORIZATION

I am an authorized agent, owner or employee of the above business (the “Member”) and have the authority to enter into a participation agreement with DINING ALLIANCE on its behalf. To the best of my knowledge, all information provided herein is correct, if DINING ALLIANCE INC. should discover that the information provided is not correct, it has the right to cancel or amend our participation in any and all programs through DINING ALLIANCE INC.

I also acknowledge that any current programs we desire to continue through a direct relationship have been disclosed and I understand that we will not be allowed to participate in the Dining Alliance Inc. program relating to those direct programs. Further, if Dining Alliance Inc. discovers that a program relating to those direct programs. Further, if Dining Alliance Inc. discovers that a program existed that was not disclosed above, we agree and authorize Dining Alliance Inc. that we wish to remain on the Dining Alliance Inc. program. Once notified, I will cancel said direct agreement within 5 business days and agree to repay any monies related to the undisclosed program(s). non-DINING ALLIANCE INC. affiliated programs the Member would like to continue have been disclosed above and that relative to those non-DINING ALLIANCE INC. programs, I acknowledge that the Member shall not be entitled to receive any rebates or other benefits from DINING ALLIANCE INC. relative to such programs. Further, if it is discovered that the Member is utilizing a program that was not disclosed above, we authorize DINING ALLIANCE INC. to allow us to remain on the DINING ALLIANCE INC. program and I will cancel said direct and conflicting agreement within 5 business days and agree to repay any monies related to the undisclosed program(s).

By signing this application, I am authorizing Dining Alliance Inc. to enroll the business listed above in all programs related to the above categories selected. I hereby authorize Dining Alliance Inc. to contact all distribution companies listed within this participation agreement in order to obtain product level data reporting for the purpose of price audit, volume allowances tracking and opportunity analysis. I agree to and acknowledge that Dining Alliance Inc. may receive financial consideration from certain program providers based on my participation through the Dining Alliance Inc. program. 

MEMBERSHIP TERMS AND CONDITIONS

I hereby agree to be contacted by Dining Alliance Inc. via telephone or email for the purpose of conducting a purchasing and/or optimization analysis on my purchases so that I may optimize my savings through Dining Alliance Inc.’s programs and for the purposes of providing me additional information on such Dining Alliance Inc. programs. I understand and consent to DA’s use of my purchasing data for the purpose of providing me with access to price deviations, for processing rebates and volume allowances available on my purchases, and in order to conduct opportunity and optimization analyses relative to my purchasing. In the aggregate, such data shall only be used to improve manufacturer awareness regarding purchasing trends and preferences relative to its products and the industry. I acknowledge and agree that Dining Alliance is entitled to receive consideration from my distributors, manufacturers, suppliers, and service and other program providers based on my purchase and participation in DA’s programs. In consideration of the benefits I will receive through my membership in Dining Alliance, I hereby agree on my own behalf and/or as an authorized agent of member, to hold Dining Alliance Inc., its affiliates, and their respective successors and assigns harmless from any and all claims, suits, causes of action, which may be asserted against them and any judgments, damages, or losses arising either directly or indirectly from my membership in Dining Alliance and/or receipt of benefits as a member thereof. Termination of membership shall only be effective upon ninety (90) days’ written notice from member.

FOR MULTIPLE LOCATIONS, OF THE SAME OPERATOR, YOU MAY USE AN EXCEL SPREADSHEET (Please List all locations to be added. Each location name must be unique, for example, Katy’s Diner-01 or Katy’s Diner-Boston, Lucky’s Casino-Housekeeping, Lucky’s Casino-Grocery, etc. If more than three locations, we ask that you please add an additional page.)