Sample Page

Open Account App

This form is monitored Monday through Friday, 8:00 am to 4:30 pm and usually requires less than one hour to process. To check on the status of a previously submitted form you can email margaret@ombps.com or call 1.866.990.1990

PLEASE NOTE THAT ALL OPEN ACCOUNTS ARE FOR PUBLICLY FUNDED FACILITIES, I.E. GOVERNMENT, CITY, STATE & COUNTY. PRIVATE COMPANIES OR INDIVIDUALS ARE NOT TYPICALLY ELIGIBLE FOR OPEN ACCOUNT STATUS UNLESS THEY MEET A VERY STINGENT SET OF REQUIREMENTS. ALL PAYMENTS ARE DUE IN NET 30 DAYS FROM RECEIPT OF INVOICE. ACCOUNTS THAT ARE PAST DUE WILL NOT BE ABLE TO PLACE ANY ORDERS UNTIL THE ACCOUNT IS CURRENT.

Are you Sales Tax Exempt?
Please Fax your Sales Tax Exmeption Form to:

Accounts Payable Information

Enter the information pertaining to who PAYS the bills.

Accounts Payable Address Accounts Payable Person's Name*
Department Name*
Mailing Address (PO Box is OK)*

CityStateZip

Contact Info: AP Phone:*ExtentionFax Number:AP Email Address (Will receive PDF copies of invoices)*

How many copies of the invoice is required?*

Shipping Information

Enter the information pertaining to where you want packages shipped.

Physical Address Department Name*
Full Street Address (NO PO Boxes)*

CityStateZip

Contact # Recipient Phone:*ExtentionFax Number:Shipping Email Address (Shipment Notices)*

Credit Information Are you a governmental agency funded by Tax Dollars?*

Entity Information What YEAR was your entity established?

Credit Reference #1 Company Name
Street Address

Contact #: Telephone:*ExtentionFax Number:Account Number

CityStateZip

Credit Reference #2 Company Name
Street Address

Contact #: Telephone:*ExtentionFax Number:Account Number

CityStateZip

Credit Reference #3 Company Name
Street Address

Contact #: Telephone:*ExtentionFax Number:Account Number

CityStateZip