GERNATT ASPHALT PRODUCTS, INC. Taylor Hollow Rd. - P.O. Box 400 - Collins, NY 14034 - Phone: (716) 532-3371 - Fax: (716) 532-9000 CREDIT APPLICATION (This application must be completed in full, signed and returned before your request can be considered.)
Company Name ______________________________________________________________________
Physical Address _____________________________________________________________________
Mailing Address _____________________________________________________________________
City ___________________________________ State _______________________ Zip ____________
Phone _________________________ Fax _________________________ E-mail __________________
OWNERSHIP:	__ Corporation	__ Partnership	__ Sole Proprietorship

DATE BUSINESS BEGAN _______________________

FEDERAL TAX ID # _______________________ (If purchases will be made tax exempt, a properly completed certificate must be on file at Gernatt before purchase is made.)

PRINCIPLE OWNERSHIP:
Name ______________________	Address _______________________	Title ____________
Name ______________________	Address _______________________	Title ____________

FINANCIAL INSTITUTION:
Name____________________	Contact_____________________	Phone________________________

COMMERCIAL CREDIT REFERENCES (must provide at least three):

Name __________________________________________________ Phone ______________________

Address __________________________________________________ Fax ______________________

Name __________________________________________________ Phone ______________________

Address __________________________________________________ Fax ______________________

Name __________________________________________________ Phone ______________________

Address __________________________________________________ Fax ______________________

GERNATT ASPHALT PRODUCTS, INC. Taylor Hollow Rd. - P.O. Box 400 - Collins, NY 14034 - Phone: (716) 532-3371 - Fax: (716) 532-9000 CREDIT APPLICATION (CONTINUED) GERNATT TERMS AND CONDITIONS OF SALE

1. All orders are accepted subject to prevailing state and local taxes.

2. Receipt of product by or on behalf of the purchaser shall be deemed to constitute acceptance by the purchaser of the product and sale in accordance with the terms set out in this agreement.

3. No product may be returned for credit except with written consent of the seller, whether such materials were ordered in excess of the purchaser's requirement, by mistake or otherwise.

4. All accounts are payable within thirty (30) days from the date of the invoice. After 30 days a finance charge will be assessed at 1 1/2% per month calculated monthly on the balance owing at the beginning of the period. In default of payment of any part of money due under this account, the whole amount remaining unpaid shall, at the option of the seller, immediately become due and payable.

5. Excessive delays incurred on delivery will be billed to the purchaser at rates in effect at the time of delay.

6. Title and ownership of the product shall not pass to the purchaser until the entire amount owing, including finance charges, is paid in full.

GERNATT CHARGE ACCOUNT AGREEMENT

For value received, and as a direct inducement to Gernatt Asphalt Products, Inc./Dan Gernatt Gravel Products, Inc. or Country Side Sand & Gravel, Inc. (Gernatt) to extend credit to ____________________________________________ (the "Company") pursuant to the Terms and Conditions set forth above, each of the undersigned do hereby, jointly and severally, unconditionally and irrevocably, guarantee the payment of any and all indebtedness incurred on the aforesaid charge account and payment of the all accrued and unpaid finance charges due thereon, and the payment of all costs and expenses (including reasonable legal expenses) paid or incurred by Gernatt in endeavoring to collect upon said indebtedness, or any part thereof, and enforcing this guarantee.

Accepted by:

Company __________________________________________________

Signature __________________________________________________ Date ______________________

Signature __________________________________________________ Date ______________________

GERNATT ASPHALT PRODUCTS, INC. Taylor Hollow Rd. - P.O. Box 400 - Collins, NY 14034 - Phone: (716) 532-3371 - Fax: (716) 532-9000 CREDIT APPLICATION (CONTINUED) AUTHORIZATION TO RELEASE INFORMATION

Bank Name ______________________________________________________________________

Bank Address _____________________________________________________________________

Phone ________________________________ Fax _______________________________

I/We hereby authorize the above named bank to release any and all information requested by Gernatt Asphalt Products, Inc., Country Side Sand & Gravel , Inc. and/or Dan Gernatt Gravel Products, Inc. relative to my/our checking and saving accounts and loan experience for the purpose of granting credit to the account named below.

Business Name ________________________________________________________________

Business Address _______________________________________________________________

Authorized Signature _____________________________________________________________

Title __________________________________ Date ______________________