Preview
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
"A"
Exhibit
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
Credit Application
15AirlineDrive
Rochester,Ny
Phone:585.235.7660 Fax:585.235.6003
wwwJfsfoods.com
BUSINESS INFORMATION:
Legal Name of BusinessEntity(Purchaser"): .
Trade Name (Doing BusinessAs):
FederalEmployer ID No.
Bill
To Ship To
Name: Name: .
Addr ss: 0 W & Address:
City
Tel. #:
State:
Fax #:
Zip: II City:
Tel. #:
State:
Fax #:
_ Zip:
Email Address: C BA " (h EmallAddress:
Length of timedoing businessunder abovename nd address:
List of
other names and addresses under
which you have operated withinthe last 5 yrs:
OWNERSHIP:(checkone) ¡ Individual/Sole
proprietorship Partnership Corporation ¡ LLC
If Corporation date
or LLC, give of Articles
and state: Date State "
lf Partnership,
is Certification
filed? O Yes O No Date City,tate
Totalpurchases are approximately $ (checkone) ¡ weekly ¡ monthly
Complete the followinginformationfor(Corporate Principal
Officers, Stockholder(5),Partnersor individual
owner(s) "
Name & Title Name & Title:
Ho Address: Home Address:
City ate: Zip: City: State: Zip:
How lon associatedw/ business: How longassociatedw/ business:
Tel. #: SSN el. #: SSN
Have youor any otherprincipal In either
participated a corporateor personal withinthelastfive
bankruptcy years? O Yes No
If so, under
what name:
Have you or any otherprincipals
been a customer of JFS Curtze
under a different
name or address? Yes o
If so, please
complete the following: FROM Month Yr. TO Month Yr.
Name:
Address: City: State:
BUSINESS REAL ESTATE:
BusinessReal Estateis(checkone): ¡ owned Mortg ed eased
Premises is mortgaged/leasedfrom: Name: .
Address:
Contact: Tef, #:
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
BU SINESS EQUIPMENT:
Business Equipment/Personal is (check one) Owned
Property Leased O 5ubject to Llen
Name of Lessor/Uen Holder: Name:
Add ress:
Contact Tel. #:
TRADE REFERENCES: food
(preferably cannotoccept
distributors; beer or IIquor
distributors
as references)
But ness N me Add ress fel6:
8 ess ame Add ress l. #:
Bus ess Name: Add ress Tel #:
*
Business Ivame: Address Tel. #:
BANK R RENCE : (p1easottachvoided checkfrom business account)
Name: ount #:
Address: Tel. II Contact:
GENERAL INFORMATION:
No. ofEmployees: SeatingCapacity: EstimatedMonthly Sales:
Buyer/PurchaserContact Accounts PayableContact
Name: Name:
Tel. #: Tel. #:
INFORMATION REGARDING TAX EXEMPTION
BLANKET SALES TAX RESALE CERTIFICATE
PURCHASER HEREBY CERTIFIES TO JFS Curtze THAT:
(1) Purchaser holds valid registration
permitnumber "
Issued under the Sales Tax Law of the State of
(2) The tangible property purchasedon eachorder we shall give, unlesssuchorder shallotherwise specify that until this notice Isrevoked by us In writing is:(checkone)
on sales tax filings as sales of tangible
or resale reported personal property
Exempt because we are Tax Exempt Institution
(pteaseottach a copy of Tax ExemptLetter)
Exempt for other
reasons.Please Explain:
(3) The unde rsigned
purchaser certifies that
further he will assume liability
for paymentof tax if he uses or consumes the herein purchased
property
as to render
in such manner to tax.
the sales subject
REGULATIONSPROVIDETHAT CERTIFICATEMUST HAVE REGISTRATIONNUMBER,ADDRESSAND SIGNATUREIN ORDERTO BE EFFECTIVE.
(This certificate
is to be considered
a part of each of Purchasers orders)
Purchaser Name By:
and Address
Print
Title:
Date
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
TERMS OF SALE ON CREDIT/CREDIT AGREEMENT/PERSONAL GUARANTEE
(PLEASE READ THIS SECTION BEFORE SIGNING)
1. The Undersigned hereby representsthathe/she is duly authorized
to sign Agreement
this Application/Credit on behalfof the above
named Purchaser and the terms
of this
Application/Credit
Agreement will be binding
upon such entity.
2. The Undersigned understand and agrees as an express
that, conditionof extending
creditin any amount,JacobsteinFood Service,
LLC a/d/b/aJFS Curtze ("JFSCurtze")requiresthis Credit be accurately
Application completed and executed. The Undersigned therefore
atteststhat the above
statementsare true,
and authorizethe investigation
of all inforrnation in this Application/Credit
listed Agreement.
3. Purchaser agrees to notify
JFS Curtze mall of any
by certified change in ownership,
or status
change which would affectthe credit
worthinessof Purchaser.
4. All amountsdue JFS Curtze are payablein accordancewith thepayment termsgranted to Purchaserby JFS Curtzewhich terms
credit
are subjectto changeat JFSCurtze's at any time.
discretion Any amount due JFS Curtze not paid in accordance
withsuch payment termswill
be subjectto a finance
charge of one and one-half
percent(1.5%)per month. Purchaser further
agrees thatit is responsible
forall expenses
includingcollection
costsand fees,attomey fees,and courtcostsincurred in the event
by Seller the accountIs tumedover to a third
party
agency or attomeyfor collection,
or anylegalactionor judicial
proceedingwhatsoever is commenced to collect
amounts owed by Purchaser.
5. In the event
a check is retumedby Purchasers Bank for insufficient
funds,an ACH payment is denied
for Insufficient
funds,or a credit
card payment is denied after
by the issuer goods are delivered,
Purchaser agreesto pay a bankserviceand inconveniencecharge of Forty
dollars($40.00)for eachsuchoccurrence.
6. In the event
the Purchaserviolatesthe terms the Undersigned
of this Agreement, authorizesany or any
Prothonotary, attomey of any
courtof recordin this
Stateor elsewhere,
to confessjudgment or judgmentsagainstthe Undersignedand Fiurchaser of the holder
and in favor
hereoffor the balance
due, togetherwiththecosts attorney's
of suit and reasonable fees,withor without release
declaration, and
of errors
withoutstayof execution; received
and for value does waive the right of any present
and benefit or future other
law of this or any state
exempUng property,real or personal,
fromlevy and saleon execution;
and, be made
if levy on real estate,
does alsowaive therightof
inquisition
and consentsto the condemnationthereofwith to sell the same
full liberty on Writof Execution,
withreleaseof errors
thereon.
7. As a condition
of JFSCurtze extendingcreditto Purchaser,
the Undersigned hereby guarantees
personally payment in full to JFS
Curtze delinquency
including charges,collection
costs and attomeyfees,and waive any presentment,demand, protest,and any othernotice
from JFS Curtzeregardingthis guaranteeof payment. It is further
agreed the useof titles with
respect indivdual
to the signaturesbelow shall
have no legalsignificance
and In no waybe construed the Undersigned
to relieve from personal under
obilgations this
paragraph.
8. for JFS
As consideration Curtze extendingcredit and in accordance
to Purchaser, withthe UniformWrittenObligationsAct, the
Undersigned and the Purchaseragree bound
to be legally and conditions
by the terms in this
Application/Credit
Agreement includingthe
personalguarantee provisionscontainedherein.
The Undersigned hereby certifies
that information
all the on thisCreditApplication
is correct,
and thatI/we fully
understand credit
terms
and conditionssetforthabove,and agree tothe termsand conditionsas for
consideration creditextendedby JFS Curtze.
Account Name:
Prinr o Purchaser
Email Address:
Signature: Date:
PrintName:
Signature: Date:
(Individually)
PrintName:
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
AUTHORIZATION AGREEMENT
FOR ELECTRONIC FUNDS TRANSFER (ACH DEBITS)
I (we) bereby authorize Jacobstein Foodservice LLC (herein after called COMPANY to initiate
debit entries tomy (our) (select one)
N Checking account OR _ Savings account
indicated below atthe depository financial institutionnamed below, hereinafter called DEPOSITORY,
and to debit the same such account, I (we) acknowledge that the origination of EFT transactions fo my
account must comply with the provisions of U.S. law.
DEPO ITORY (Bank) NAME:
CITY ZIP
ROUTING/TRANSIT NUMB
BANK ACCOUNT NUMB
NOTE: Deductions will be initiated each and every Wednesday, unless precluded by a bank holiday.
This authorization isto remain in fullforce and effect untilCOMPANY has received written notification
from me (or eitherof us) of its terrnination in such time and insuch manner as to afford CO14VANY and
DEPOSITORY a reasonable opportunity to act on it.
CUSTOMER NAME: CUSTOMER #
SIGNATURE: DATE: . a
PRINT NAME:
E-mail address:
Return Completed F9rm to:
Jacobstein Foodservice LLC - Finance Dept
15 Airline Drive
Rochester, NY 14624
Fax 585-235-6003
e-mail:accounting@jfsfoods.com
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022
so-n' ²²'3
THE EATERY 1026
PH. 315-783-5349
170 COURT ST.
WATERTOWNFNY 13601
DATE
. PAY TO THE
Watertown
Savidgs Bank
WATERTOWN,NEW òORK 13001 /
"
it 2 2 3 ? L 3 5Gi: O L L 277005 LO 26
Preview
FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 "A" Exhibit FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 Credit Application 15AirlineDrive Rochester,Ny Phone:585.235.7660 Fax:585.235.6003 wwwJfsfoods.com BUSINESS INFORMATION: Legal Name of BusinessEntity(Purchaser"): . Trade Name (Doing BusinessAs): FederalEmployer ID No. Bill To Ship To Name: Name: . Addr ss: 0 W & Address: City Tel. #: State: Fax #: Zip: II City: Tel. #: State: Fax #: _ Zip: Email Address: C BA " (h EmallAddress: Length of timedoing businessunder abovename nd address: List of other names and addresses under which you have operated withinthe last 5 yrs: OWNERSHIP:(checkone) ¡ Individual/Sole proprietorship Partnership Corporation ¡ LLC If Corporation date or LLC, give of Articles and state: Date State " lf Partnership, is Certification filed? O Yes O No Date City,tate Totalpurchases are approximately $ (checkone) ¡ weekly ¡ monthly Complete the followinginformationfor(Corporate Principal Officers, Stockholder(5),Partnersor individual owner(s) " Name & Title Name & Title: Ho Address: Home Address: City ate: Zip: City: State: Zip: How lon associatedw/ business: How longassociatedw/ business: Tel. #: SSN el. #: SSN Have youor any otherprincipal In either participated a corporateor personal withinthelastfive bankruptcy years? O Yes No If so, under what name: Have you or any otherprincipals been a customer of JFS Curtze under a different name or address? Yes o If so, please complete the following: FROM Month Yr. TO Month Yr. Name: Address: City: State: BUSINESS REAL ESTATE: BusinessReal Estateis(checkone): ¡ owned Mortg ed eased Premises is mortgaged/leasedfrom: Name: . Address: Contact: Tef, #: FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 BU SINESS EQUIPMENT: Business Equipment/Personal is (check one) Owned Property Leased O 5ubject to Llen Name of Lessor/Uen Holder: Name: Add ress: Contact Tel. #: TRADE REFERENCES: food (preferably cannotoccept distributors; beer or IIquor distributors as references) But ness N me Add ress fel6: 8 ess ame Add ress l. #: Bus ess Name: Add ress Tel #: * Business Ivame: Address Tel. #: BANK R RENCE : (p1easottachvoided checkfrom business account) Name: ount #: Address: Tel. II Contact: GENERAL INFORMATION: No. ofEmployees: SeatingCapacity: EstimatedMonthly Sales: Buyer/PurchaserContact Accounts PayableContact Name: Name: Tel. #: Tel. #: INFORMATION REGARDING TAX EXEMPTION BLANKET SALES TAX RESALE CERTIFICATE PURCHASER HEREBY CERTIFIES TO JFS Curtze THAT: (1) Purchaser holds valid registration permitnumber " Issued under the Sales Tax Law of the State of (2) The tangible property purchasedon eachorder we shall give, unlesssuchorder shallotherwise specify that until this notice Isrevoked by us In writing is:(checkone) on sales tax filings as sales of tangible or resale reported personal property Exempt because we are Tax Exempt Institution (pteaseottach a copy of Tax ExemptLetter) Exempt for other reasons.Please Explain: (3) The unde rsigned purchaser certifies that further he will assume liability for paymentof tax if he uses or consumes the herein purchased property as to render in such manner to tax. the sales subject REGULATIONSPROVIDETHAT CERTIFICATEMUST HAVE REGISTRATIONNUMBER,ADDRESSAND SIGNATUREIN ORDERTO BE EFFECTIVE. (This certificate is to be considered a part of each of Purchasers orders) Purchaser Name By: and Address Print Title: Date FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 TERMS OF SALE ON CREDIT/CREDIT AGREEMENT/PERSONAL GUARANTEE (PLEASE READ THIS SECTION BEFORE SIGNING) 1. The Undersigned hereby representsthathe/she is duly authorized to sign Agreement this Application/Credit on behalfof the above named Purchaser and the terms of this Application/Credit Agreement will be binding upon such entity. 2. The Undersigned understand and agrees as an express that, conditionof extending creditin any amount,JacobsteinFood Service, LLC a/d/b/aJFS Curtze ("JFSCurtze")requiresthis Credit be accurately Application completed and executed. The Undersigned therefore atteststhat the above statementsare true, and authorizethe investigation of all inforrnation in this Application/Credit listed Agreement. 3. Purchaser agrees to notify JFS Curtze mall of any by certified change in ownership, or status change which would affectthe credit worthinessof Purchaser. 4. All amountsdue JFS Curtze are payablein accordancewith thepayment termsgranted to Purchaserby JFS Curtzewhich terms credit are subjectto changeat JFSCurtze's at any time. discretion Any amount due JFS Curtze not paid in accordance withsuch payment termswill be subjectto a finance charge of one and one-half percent(1.5%)per month. Purchaser further agrees thatit is responsible forall expenses includingcollection costsand fees,attomey fees,and courtcostsincurred in the event by Seller the accountIs tumedover to a third party agency or attomeyfor collection, or anylegalactionor judicial proceedingwhatsoever is commenced to collect amounts owed by Purchaser. 5. In the event a check is retumedby Purchasers Bank for insufficient funds,an ACH payment is denied for Insufficient funds,or a credit card payment is denied after by the issuer goods are delivered, Purchaser agreesto pay a bankserviceand inconveniencecharge of Forty dollars($40.00)for eachsuchoccurrence. 6. In the event the Purchaserviolatesthe terms the Undersigned of this Agreement, authorizesany or any Prothonotary, attomey of any courtof recordin this Stateor elsewhere, to confessjudgment or judgmentsagainstthe Undersignedand Fiurchaser of the holder and in favor hereoffor the balance due, togetherwiththecosts attorney's of suit and reasonable fees,withor without release declaration, and of errors withoutstayof execution; received and for value does waive the right of any present and benefit or future other law of this or any state exempUng property,real or personal, fromlevy and saleon execution; and, be made if levy on real estate, does alsowaive therightof inquisition and consentsto the condemnationthereofwith to sell the same full liberty on Writof Execution, withreleaseof errors thereon. 7. As a condition of JFSCurtze extendingcreditto Purchaser, the Undersigned hereby guarantees personally payment in full to JFS Curtze delinquency including charges,collection costs and attomeyfees,and waive any presentment,demand, protest,and any othernotice from JFS Curtzeregardingthis guaranteeof payment. It is further agreed the useof titles with respect indivdual to the signaturesbelow shall have no legalsignificance and In no waybe construed the Undersigned to relieve from personal under obilgations this paragraph. 8. for JFS As consideration Curtze extendingcredit and in accordance to Purchaser, withthe UniformWrittenObligationsAct, the Undersigned and the Purchaseragree bound to be legally and conditions by the terms in this Application/Credit Agreement includingthe personalguarantee provisionscontainedherein. The Undersigned hereby certifies that information all the on thisCreditApplication is correct, and thatI/we fully understand credit terms and conditionssetforthabove,and agree tothe termsand conditionsas for consideration creditextendedby JFS Curtze. Account Name: Prinr o Purchaser Email Address: Signature: Date: PrintName: Signature: Date: (Individually) PrintName: FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 AUTHORIZATION AGREEMENT FOR ELECTRONIC FUNDS TRANSFER (ACH DEBITS) I (we) bereby authorize Jacobstein Foodservice LLC (herein after called COMPANY to initiate debit entries tomy (our) (select one) N Checking account OR _ Savings account indicated below atthe depository financial institutionnamed below, hereinafter called DEPOSITORY, and to debit the same such account, I (we) acknowledge that the origination of EFT transactions fo my account must comply with the provisions of U.S. law. DEPO ITORY (Bank) NAME: CITY ZIP ROUTING/TRANSIT NUMB BANK ACCOUNT NUMB NOTE: Deductions will be initiated each and every Wednesday, unless precluded by a bank holiday. This authorization isto remain in fullforce and effect untilCOMPANY has received written notification from me (or eitherof us) of its terrnination in such time and insuch manner as to afford CO14VANY and DEPOSITORY a reasonable opportunity to act on it. CUSTOMER NAME: CUSTOMER # SIGNATURE: DATE: . a PRINT NAME: E-mail address: Return Completed F9rm to: Jacobstein Foodservice LLC - Finance Dept 15 Airline Drive Rochester, NY 14624 Fax 585-235-6003 e-mail:accounting@jfsfoods.com FILED: JEFFERSON COUNTY CLERK 09/23/2022 03:17 PM INDEX NO. EF2022-00002583 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 09/23/2022 so-n' ²²'3 THE EATERY 1026 PH. 315-783-5349 170 COURT ST. WATERTOWNFNY 13601 DATE . PAY TO THE Watertown Savidgs Bank WATERTOWN,NEW òORK 13001 / " it 2 2 3 ? L 3 5Gi: O L L 277005 LO 26