Municipal Account Form - The Vellano Corporation

VELLANO
Municipal Account Form
The Vellano Corporation
Vellano Bros., Inc.
A.J. Vel., Ltd.
Vellano Technologies
Vellano Utility Services
Application must be completed in its entirety and
returned to:
7 Hemlock St., Latham, NY 12110
518-785-5537 • Toll free: 800-342-9855
Fax: 518-785-5561 • www.vellano.com
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VELLANO
MUNICIPAL ACCOUNT DATA SHEET
Municipality Full Name
Proper Billing Address
Accounts Payable Information
Contact:
Email:
Phone:
Fax:
DEPARTMENT CONTACTS
Water Dept:
Shipping Address
Contact:
Email:
Phone:
Fax:
Sewer Dept:
Shipping Address
Contact:
Email:
Phone:
Fax:
Highway Dept:
Shipping Address
Contact:
Email:
Phone:
Fax:
BILLING PROCEDURES
Is a purchase order required?
q Yes
q No
Is a voucher required
q Yes
q No
Will you accept a “Claimant’s Certification”
stamp in lieu of a voucher?
q Yes
q No
For internal use:
Branch: ____________________ Salesperson: ________________
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Pricing Class: ________
VELLANO
MUNICIPAL SPECIFICATIONS
Municipality Full Name:
Contact:
Name:
Email:
HYDRANT
Accepted Manufacturer(s):
Color:
Direction of Opening:
q Left (OL)
q Right (OR)
Valve Size:
q 4 1/2”
q 5 1/4”
Direction of Opening:
q Left (OL)
q Right (OR)
Resilient Wedge Gate Valve:
q Yes
q No
q Domestic
q Foreign
q No Requirement
q PVC
q Ductile
q Polyethylene
q Ductile
q Stainless
q No Requirement
q Domestic
q Foreign
q No Requirement
q Copper
q Polyethylene
q No Requirement
q No Requirement
LINE VALVES
Accepted Manufacturer(s):
VALVE BOX REQUIREMENT
Type:
WATER MAIN
Pipe Material:
Class:
Tapping Sleeve:
RESTRAINT/ MJ FITTINGS REQUIREMENT
Type:
Restraint Type:
Manufacturer Requirement:
SERVICES
Accepted Manufacturer(s):
Material:
Curb Stop Style:
q Plug
q Ball
Drain:
q Yes
q No
End Connection Type:
q Flare
q Compression
Curb Box Style:
q Erie 2 Hole
q Erie Plug
q 94E/ Buffalo
Curb Box:
q Domestic
q Foreign
q No Requirement
Metered?:
q Yes
q No
If yes:
Meter Manufacturers:
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q No Req.
VELLANO
MUNICIPAL SPECIFICATIONS, CONTINUED
Meter Box:
q Plastic
Meter Box Lid:
q Plastic with CI Reader
q Solid Plastic
q Concrete with CI Reader
q Solid CI
q Cast Iron with CI Reader
q Other _______________
q Brass with Double Brass Strap
q Brass Hinged
q Brass w Stainless Double Strap
q DI w Double Strap
q DI w Stainless Double Strap
q Other _______________
q Compression
q FIP
q Meter Tail Nut
q Compact
q Flare
q Other _______________
q SDR35
q SDR26 Heavywall
q Truss Pipe
q DI
Saddle Requirement:
Meter Valve:
Sewer Pipe:
Vault Requirements:
Additional Specifications:
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q Concrete
q Cast Iron
VELLANO
ALL SALES WILL BE SUBJECT TO THE FOLLOWING TERMS
RETURNED MATERIAL: When orders have been filled as specified, no goods may be returned by
the Purchaser, nor will any credit be allowed, unless written consent has first been obtained from a
representative of The Vellano Corporation, Vellano Bros., Inc., A.J. Vel, Ltd. (Vellano Technologies), Anjo
Construction, Ltd. (Vellano Utility Services) (hereinafter referred to as the Companies). When so obtained, the Companies’ present policy, subject to change without further notice, is to accept returned
material if it, in the Companies sole discretion, finds such material to be standard stock and in good
condition. Such credit shall be the invoice price less twenty-five (25) percent on accepted material, less
all shipping and handling charges. In all other cases, the credit, solely determined by the Companies,
shall be the scrap value of the goods, less shipping and handling charges.
MANUFACTURERS WARRANTY: Goods sold by the Companies are covered by the manufacturer’s warranty and are covered only to the extent of the manufacturer’s warranty. The manufacturer’s warranty which is given expressly and in lieu of all other warranties, expressed or implied, of merchantability and fitness for particular purpose, constitutes the only warranty made
by the Companies and provided to the Purchaser. There are no warranties of merchantability or
fitness for a particular purpose provided.
TERMS OF PAYMENT: Terms are net thirty (30) days from invoice date. Payment is due within terms
regardless of whether the Purchaser has been paid for said materials. The Companies reserve the right
to demand payment in full with all accrued service charges at any time after the first service charge has
accrued. PURCHASER AGREES TO PAY ALL OF COMPANIES’ ATTORNEY’S FEES TOGETHER WITH
ALL COSTS AND DISBURSEMENTS INCURRED IF THE ACCOUNT IS PLACED WITH AN ATTORNEY
FOR COLLECTION.
This agreement will be governed by, construed and enforced in accordance with Federal Law and the
Laws of the State of New York. Credit has been provided Purchaser in the State of New York. Purchaser hereby waives the right to a jury trial in any action or proceeding brought by either party against
the other in the enforcement of this agreement. The Purchaser agrees that all actions to enforce this
agreement will be venued in Albany County, State of New York or any other jurisdiction deemed appropriate by the Companies.
The undersigned thoroughly and completely understands and agrees to the above terms and conditions of credit with the Companies and is duly authorized by the customer to execute this document
and bind customer to Companies’ terms.
Name of Customer
By:
Date:_______________Signature and Title
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