1099 Worker
PAYMENT ADVANCE REQUEST

Business Information

Accounts Payable Contact Information

Billing Address

Principle Contact Information

Bank Reference

Trade Reference

ACH Autopay

Billing Information

Payment terms: Net 15
Late payments: All amounts paid after the due date will be assessed a late payment charge of (1.5%) per month.
Billing: Billing will occur at the end of each day once services provided by contractors have been verified.
Accounting contact: accounting@baconinc.com

Signature Block

You represent you are an authorized representative with authority to enter into this agreement and the information contained in this Application and any attachment is true, correct and complete. You consent to Vendor obtaining information about you personally and the Applicant from credit reporting agencies and other sources Vendor deems appropriate in considering this Application. If credit is extended, you agree to be bound by all of the terms and conditions on Vendor’s invoices and posted on Vendor’s website.
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