Superior Signs Company: Customer Information Sheet

All of the below information must be completed for application to be processed
Upon filling in all fields you will be taken to another page where you can print and sign the form then fax it over to us

Office Name:

Office Address: Street Ste#: City: Zip:

Agent/Responsible Party Full Name:
Use "909-555-4444" format
Telephone: Fax: Cell Phone:

E-mail Address:

Credit Card Information Required:
Name as it apears on credit card:

M/C or VISA # Exp Date: (MM/YYYY)
*(Below please indicate billing address of where your credit card statement is mailed to for security purposes)*
Billing Address: Street Ste#: City: Zip:


Superior Signs provides the service of Installation and removal of Real Estate Posts to Realtors for the purposes of displaying signs provided by the realtor. All Materials provided by Superior Signs are to remain the property of Superior Signs. Superior Signs Provides Service in portions of San Bernardino, Los Angeles, Orange, and Riverside Counties for one low price The agent will be notified if an order is outside our basic service area. . Superior Signs is not responsible for any property not belonging to Superior Signs. Installation Orders within our basic service area will be completed the following business day providing all of the following criteria are met. Correct address, cross street, and Thomas Guide coordinates are provided. Company and/or agent information is provided. The property is accessible. Order is placed before 2p.m. and before 6p.m. on Fridays. Orders placed after 2p.m. (6p.m. on Friday) will be considered received the following business day. Any delays caused by the failure to furnish the correct or complete information, will be the responsibility of the agent, or person placing the order. Once an installation is completed the property becomes the sole responsibility of the account holder. Superior signs will not be responsible for damages resulting from the moving or removing of a post not authorized by Superior Signs. Posts are not to be moved or relocated without express permission granted by Superior Signs. There will be a $35.00 lost post charge. Superior Signs will not be responsible for any lost, stolen, or damaged property not belonging to Superior Signs throughout the duration of this service agreement. Installation Period is for 6 months from the installation date on one location for one fee, upon the expiration of 6 months the agent will be notified that the post is going past the 6 month period, at which time the agent has the option to extend the service contract for a small fee. Statements will be mailed on the 1st day of each month. A 10 percent late charge applies after the 15th of the month if payment is not collected. Past due accounts may be subject to removal of all property at our discression. This Agreement is at will, and either party may cancel this agreement at any time. Upon termination of this agreement Superior Signs reserves the right to recover all property belonging to Superior Signs. Superior Signs will provide the best quality of reliable, friendly service as well as do the best in selecting a sign location, and remember, Nothing sells a property like a SUPERIOR SIGN.

By signing below you agree to abide by the terms set forth in the above paragraph, and to be responsible for all charges on the above listed credit card relating to this account.

Signed: ____________________________________ Date: ____________