Peerless honors company purchase orders for those companies who have approved credit. If you do not already have an account with us and would like one established, please fill out the information on the form below and click on the submit button. Once the information has been submitted, our accounting department will review your application and establish an account for your company.

In addition to accepting company purchase orders, Peerless also accepts VISA, Master Card and COD orders. If you have any questions on payment options, or require further information on setting up an account, please contact our accounting department. To see a directory of contacts, please CLICK HERE.

 

Comapny Information

Company Name:

AddressLine 1:

Address Line 2:

Address Line 3:

City:

State:

Other State:

Zip-Code:

Country:

Other Country:

Phone:

Fax:

Accounts Payable Contact:

DUNS Number:


Bank Reference

Name:

Address Line 1:

Address Line 2:

City:

State:

Other State:

Country:

Other Country:

Phone:

Fax:

Contact Person:


Trade References (Please Enter Three)

Name:

Address Line 1:

Address Line 2:

City:

State:

Other State:

Country:

Other Country:

Phone:

Fax:

Contact Person:


Name:

Address Line 1:

Address Line 2:

City:

State:

Other State:

Country:

Other Country:

Phone:

Fax:

Contact Person: