Application for Credit/Credit Agreement

Credit approval cannot be granted without a completed, signed application. Credit terms: 1% / 10 days, Net 30 unless otherwise specified.

I acknowledge that I am an authorized representative of my company and can on their behalf apply for and accept the terms of credit offered by Nox-Crete, Inc. I authorize release of credit information to Nox-Crete, Inc. for this purpose.

Email completed and signed form to Brandee Krueger at bkrueger@nox-crete.com.