Account Application
BUSINESS INFORMATION
Full Legal Name of Business Entity

Tax ID Number

Billing Street Address
Billing City/State/Zip
Shipping Street Address
Shipping City/State/ZipWebsite
Nature of BusinessBusiness TypeYear Established
CorporationPartnership

LLC

Not-for-Profit

State or Local Gov’t

PURCHASING & PAYMENT

Accounts Payable Contact (Name, Phone, Email)Purchasing Contact (Name, Phone, Email)
Estimated Monthly Purchase AmountTerms

No terms required – credit card purchases

Purchase Order Required
Intended Product Use

Yes
Lab Research

Net 30 terms desired
NoResale

Further Manufacture

OtherTax Status

Tax Exempt (provide Tax Exemption Certificate)

Non-Exempt

TRADE REFERENCES

Note: Three trade references are required to process the application. However, we suggest providing a fourth reference in the case that one ofyour references is unresponsive.
Company Name

Contact

Contact EmailContact Phone

Company Name

Contact

Contact EmailContact Phone

Company Name

Contact

Contact EmailContact Phone

Company Name

Contact

Contact EmailContact Phone

Page 1

Terms and Conditions
By agreeing to the terms and conditions below, I hereby represent that I am authorized to submit this application and bind the business
identified in this application, to be subsequently referred to as Applicant, and the information provided is for obtaining credit and is true
and accurate.
The business identified in this application acknowledges that this request is for the extension of credit for commercial purposes only andis not intended for the extension of credit for person, family or household purposes. To protect individual identities, unless an individual
is intending to act as a guarantor for purposes of securing credit and is required to provide guarantor information on this application, no
personally identifying information (i.e. Social Security #, drivers license #, bank account information, etc.) should be provided.
Applicant hereby authorizes all banks, financial institutions, trade reference sources, credit reporting agencies and others to releasecredit information.
In the event of a conflict, the terms and conditions as stated on our website shall control over any terms and conditions set forth below.
All sales by Bio-Techne Corporation and its affiliates, herein collectively referred to as Bio-Techne, are subject to the terms andconditions provided on our website. Bio-Techne rejects any different or additional terms or conditions contained in any document
submitted by Applicant. Bio-Techne’s acceptance of any purchase order and/or sale of any goods is made conditional on Applicant’s
assent to these terms and conditions.
All taxes of any kind levied by any federal, state, municipal or other governmental authority which Bio-Techne is required to collect or
pay with respect to the production, sale or shipment of goods sold to Applicant shall be the responsibility of the Applicant. Applicant
agrees to pay all such taxes and further agrees to reimburse Bio-Techne for any such payments made by Bio-Techne. Applicant isresponsible for providing the legitimate applicable tax exemption, resale certificate or other formal documentation to declare tax exempt
status. Bio-Techne is legally obligated to charge tax until proper tax exemption is on file.
Payment, whether full or partial, received from or for the account of Applicant, shall be applied by Bio-Techne against any amountowing by Applicant with full reservation of all Bio-Techne rights, without accord and satisfaction of Applicant’s liability, regardless ofwritings, legends or notations upon such checks or payments, or regardless of other writings, statements or documents.
Unless otherwise indicated, payment terms are net 30 days from date of invoice.
It is understood and agreed that Applicant will pay all amounts owing to Bio-Techne according to terms stated on Bio-Techne invoices,and will pay reasonable collection fees, attorney fees, and court costs incurred in collections of Applicant’s account.
This agreement shall be governed by the laws of the state of Minnesota, USA. Applicant, acting for itself and its successors andassigns, hereby expressly and irrevocably consents to the exclusive jurisdiction of the state and federal courts of that state for any
litigation which may arise out of or be related to this agreement. Applicant waives any objection based on form non conveniens or any
objection to venue of any such action.
Bio-Techne reserves the right to enforce these terms and conditions at any time and none shall be deemed waived unless waiver is in
writing signed by a duly authorized employee of Bio-Techne. All rights and remedies granted herein are in addition to all remediesavailable at law or in equity.

I agree to the terms and conditions above.

Name

Email

Authorized Signature

Professional Title

Page 2Bank Reference Authorization
BANK REFERENCE INFORMATION:
Bank NameBank Address
Account/Loan Officer

Phone

Email

CUSTOMER INFORMATION:
Customer Name

Account Number

Routing Number

Street Address

City, State, Zip

The above information is given for obtaining credit privileges with Bio-Techne and is true to the best of my/our knowledge. I/we hereby
authorize Bio-Techne to contact the bank reference listed, as well as any credit investigational organizations, for evaluation of my/ourcredit worthiness and financial responsibility. It is understood and agreed that I/we will pay all amounts owing to Bio-Techne according
to terms stated on Bio-Techne invoices, and will pay reasonable collection fees, attorney fees, and court costs incurred in collections ofmy/our account.
Authorized By (print):

Signature:

Professional Title:

Date:~~~Reference Portion~~~CHECKING ACCOUNT INFORMATION
Date Account Opened

Average Balance

Returned Items

SatisfactoryYes

NoYes

No

LOAN INFORMATION
Date Opened
SecuredYes

SecuredBank Signature/ Title:

BalanceSecured byPayment (poor/fair/good)High Credit

BalanceSecured byPayment (poor/fair/good)

No

Date OpenedYesHigh Credit

No
Date:
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Trade Reference Authorization
TRADE REFERENCE:
Company Applying for Credit

Reference Company Name

Street Address

Phone/EmailCity, State, Zip

The above information is given for obtaining credit privileges with Bio-Techne and is true to the best of my/our knowledge. I/we hereby
authorize Bio-Techne to contact the bank reference listed, as well as any credit investigational organizations, for evaluation of my/ourcredit worthiness and financial responsibility. It is understood and agreed that I/we will pay all amounts owing to Bio-Techne according
to terms stated on Bio-Techne invoices, and will pay reasonable collection fees, attorney fees, and court costs incurred in collections ofmy/our account.

Authorized By (print):

Signature:

Professional Title:

Date:

Page 4