–
Ardent Mills Flour Inquiry Form
& Credit Application
Dear Sir/Madame,
Thank you for your interest in Ardent Mills flour!
Below you will find two documents that we require every new customer to complete.
The first is the “Flour Inquiry Form” which we use to understand what your needs are and how we can best
help you. The second is our credit application. This is required for all potential customers, regardless of
how you may finance future purchases. We use this information to better understand your business.
Before we can proceed, both of these documents must be completely and accurately filled out. In
order to send you a price indication, we would appreciate if you can send us information about the type of
products that you are considering and are already commercializing.
We would also appreciate if you can send some basic information about your company, such as whether
you are a bakery or distributor, what your product line is, what your distribution capabilities are, whether
you have warehouses, what type of distribution equipment you have, who your end user is, etc.
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We will need the following information as well, before we can send price indication (Please respond to all
9 questions, in order to get a response back):
1. Full flour specification (Minimum % protein, ash, moisture, etc. Because we do not test for gluten
content in the USA or Canada we must have % protein)
2. Any other special requirements (Bleached, fortified, malted, bromated, etc.)
3. Full documentation requirements (in order to be imported into final destination)
4. Intended volume (per month) **Minimum purchases are 20 MT**
5. Shipment time
6. Packaging size
7. Container freight basis i.e. FOB mill/port or delivered somewhere; if delivered, where
8. Price willing to pay
9. Payment (cash in advance for first loads, then Pre-approved LC)
Send the completed forms to [email protected].
If you have any questions, please let us know. We look forward to hearing from you!
Regards,
Export Division
Customer name
SELLER:
SOLD TO:
Ardent Mills LLC
15407 MCGINTY ROAD WEST – MS #61
WAYZATA, MN 55391
USA
PICK-UP LOCATION:
SHIP TO:
PLACE OF DELIVERY:
CONSIGNEE:
OCEAN FREIGHT:
NOTIFY PARTY:
COLLECT
PREPAID
FOB Plant
MOVE TYPE:
DOOR/PORT
PORT/DOOR
PORT/PORT
TYPE OF SHIPMENT
OCEAN
DOCS TO:
TRUCK
CUSTOMER PICK UP
INCOTERMS:
Ex-works
CIF
CONTAINER SIZE:
40
20
PAYMENT TERMS:
DOCUMENTATION REQUIRED
BILL OF LADING
SEAWAY BILL
PRO-FORMA INVOICE
AIRWAY BILL
PACKING LIST
COMMERCIAL INVOICE
NAFTA
CERT OF FREE SALE
CAFTA
CERT OF GMO FREE
CARICOM
CERT OF ORIGIN
CERT OF ANALYSIS
PHYTOSANITARY CERTIFICATE REQUIRED
WOOD PACKING STATEMENT (ISPM-15)
CONSULRIZATION
FUMIGATION REQUIRED
KOSHER CERTIFICATE
ANY OTHER COUNTRY REQUIREMENTS OR COMMENTS
R evis ed 8 _ 2 1_ 13
Ardent Mills Credit Application
**** Forward Completed Application to Your Salesperson or Customer Service Representative ****
***ALL INFORMATION IS REQUIRED***
PLEASE PROVIDE ALL OF THE INFORMATION REQUESTED.
MISSING INFORMATION WILL DELAY APPLICATION PROCESSING.
T o b e c ompl e te d b y A r de nt M i l l s R e p
AMOUNT OF CREDIT REQUESTED: $
SALESPERSON:
C O M P A N Y L E G A L N A M E :
S T R E E T A D D R E S S :
C ity:
S ta te :
Z ip :
M A IL IN G A D D R E S S ( B illin g ) :
C ity:
S ta te :
Z ip :
T E L E P H O N E # :
F A X # :
C o . C o n ta c t N a m e :
P R IN C IP A L O WN E R ( S ) o r O F F IC E R ( S ) N A MS ES N
T IT L E
C o . C o n ta c t P e rs o n E M A IL :
C o C o n ta c t P h o n e # :
F e d ID # & D N B # :
P a re n t C o m p a n y:
S T A R T U P Y E A R :
C O . T R A D E N A M E :
S T A T E O F IN C O R P O R A T IO N :
P a re n t C o A d d re s s :
B U S IN E S S F O R M E R L Y K N O WN A S :
B U S IN E S S S T R U C T U R E : | | P ro p rie to rs h ip | | P a rtn e rs h ip | | C o rp o ra tio n | | L .L .C . H O W WO U L D Y O U P R E F E R T O R E C E IV E Y O U R IN V O IC E S ?
F A X : | | Y E S | | N O
E m a il A d d re s s :
C ity, S ta te , Z ip :
E M A IL : | | Y E S | | N O
M A IL : | | Y E S | | N O
E R S : | | Y E S | | N O
F a x # :
BANK REFERENCE
P R IM A R Y B A N K N A M E :
T e le p h o n e :
A d d re s s :
R o u tin g /T ra n s it ( 9 D i g i t s ) :
C ity:
S ta te :
F a x / E m a il:
B a n k C o n ta c t N a m e :
Z ip :
A c c t# : | | D e p
o
s it | | L o a n | | C re d it L in e
TRADE REFERENCES
NAME:
T e le p h o n e :
F a x:
E m a il:
A d d re s s :
C ity:
S ta te :
Z IP :
NAME:
T e le p h o n e :
F a x:
E m a il:
A d d re s s :
C ity:
S ta te :
Z IP :
NAME:
T e le p h o n e :
F a x:
E m a il:
A d d re s s :
C ity:
S ta te :
Z IP :
NAME:
T e le p h o n e :
F a x:
E m a il:
A d d re s s :
C ity:
S ta te :
Z IP :
B a n k ru p tc y? Y e a r:
C la im s o r L a ws u its ?
J u d g m e n ts A g a in s t Y o u ?
| | Y E S | | N O
| | Y E S | | N O
| | Y E S | | N O
A R E Y O U C U R R E N T L Y IN V O L V E D IN , O R H A V E O N F IL E , A N Y O F T H E F O L L O WIN G :
FINANCIAL STATEMENT: We w ould appreciate receiving a copy of your latest Audited Financial Statement. We hold ALL
financial information in confidence as described below . This information w ill be used for credit purposes only.
| | F inanc ial S tatement E nc lo s ed | | F inanc ial S tatement M ailed Under S eparate C o v er | | O ther _ __________________________________
****Signatures Required For Application To Be Considered****
See Page 2
****Signatures Required For Application To Be Considered****
The undersigned hereby authorizes any bank, other grantor of credit and/or any consum er reporting agency to provide Ardent Mills,LLC (or any of its subsidiaries
or affiliates or agents) (collectively, "Ardent Mills") copies of (i) the aforem entioned com pany's financial statem ents (including w ithout lim itation balance sheets and
incom e or cash flow statem ents) and (ii) any "consum er report" or "investigative consum er report" for the undersigned individual, and/or (iii) any other report or
inform ation relating to the aforem entioned Com pany's or undersigned individual's credit w orthiness, credit standing, credit capacity, or m ode of operation. Ardent
Mills w ill only request consumer credit information on the undersigned individual if the undersigned is applying for credit as an individual or if the undersigned's consumer credit information is
necessary for Ardent Mills to consider granting credit to the aforementioned Company. The aforementioned Company and the undersigned individual acknow ledges that this application
constitutes his/her or its w ritten consent for Ardent Mills to request such financial statements, reports and or information (collectively, the "Information”) and to disclose the Information to
any third party (i) to w hom one or more of your payment obligation may be assigned by us or (ii) upon w hose evaluations w e rely on in making a credit decision regarding your account.
Information w ill be used solely for the purposes of establishing and monitoring credit, determining w hen credit should no longer be extended and collecting credit extended to you. The
undersigned individual, on behalf of him/herself and the aforementioned Company, hereby releases Ardent Mills and each person disclosing any of the Information from any and all claims,
demands, losses, liabilities, costs or expenses w hich may arise or w hich the aforementioned Company or the undersigned individual may incur by reason of the disclosure of such
Information. Should credit be granted by Ardent Mills all decisions w ith respect to the extension, the continuation or the termination of credit and the amount of any credit extended, from
time to time, shall be at the sole discretion of Ardent Mills. Updated credit information or financial statements may be required, and customer w ill need to provide accordingly. For greater
clarity, Ardent Mills w ill have the right to terminate credit availability and/or reduce the amount of credit extended, at any time at its sole discretion. Company agrees to pay Ardent Mills (i)
interest on all late payments at a rate, from time to time, determined by Ardent Mills and notified to the aforementioned Company or undersigned individual, (ii) for all costs, expenses and
fees for the collection of amounts ow ed to Ardent Mills, including attorneys fees if your account is placed w ith counsel for collection. Com pany prom ises to pay for all purchases
from Ardent Mills in accordance w ith Ardent Mills term s of sale as stated on its invoices and sales contracts. Paym ents w ill be considered late if they are not
received by Ardent Mills on or before the paym ent due date.
P e rs o n T o C o n ta c t R e g a rd in g A c c o u n ts T Pelepho
a ya b ne:
le :
A u th o riz e d S ig n a tu re (REQUIRED):
A u th o riz e d S ig n a tu re D a te (REQUIRED):
T IT L E :
DATE:
The undersigned individual w ho is a principal of the credit applicant as a sole proprietor, partner or stockholder, recoginizing that his or her individual credit history may be a factor in the
evaluation of the credit history of the applicant, hereby consents to and authorizes Ardent Mills to obtain, share and use all available consumer credit reports for the undersigned from time
to time as may be needed, in its evaluaion of the credit applicant's request for credit, and its extension, review , modification, and any collection activities related thereto.
S O C IA L S E C U R T IY # :
P R IN T N A M E :
IN D IV ID U A L S IG N A T U R E :
DATE:
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided
that the applicant has the capacity to enter into a binding contact); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in
good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance w ith this law concerning the creditor is the Federal Trade
Commission, Equal Credit Opportunity, Washington, D. C. 20580.
If w e take adverse action on your request for open credit, you have a right w ithin 60 days to request in w riting specific reasons for this action and w e w ill respond in w riting w ithin 30
days. Our address is Eleven ConAgra Drive, Omaha, NE 68102
**** Forward Completed Application to Your Salesperson or Customer Service Representative ****