Account Application Person Completing Application First Last Email General InformationLegal Company Name Doing Business As: Street Address Floor/Suite # City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip CodePhonePhone ExtensionFaxWebsite Years in Business How Did You Hear About Us? Primary Contact Responsible For Paying InvoicesName Title PhonePhone ExtensionFaxCellEmail Additional Contact Responsible For Paying InvoicesName Title PhonePhone ExtensionFaxCellEmail Primary Contact that Places OrdersName Title PhonePhone ExtensionFaxCellEmail Additional Contact that Places OrdersName Title PhonePhone ExtensionFaxCellEmail MADI Express Inc. DBA Millennium Dispatch ( MD ) does not take responsibility for cash, jewelry, securities, and fine art. MD limits its liability to a maximum of $100 per delivery unless otherwise negotiated prior to the pickup of the delivery documented in an email format from MD. You the customer acknowledges and agrees to the following: Payment for all work performed by MD is personally, jointly, severally, and unconditionally guaranteed within 30 days of billing. A late charge of 1 ½ % per month will be added to accounts not paid within 30 days. All claims, requests for adjustments, or notification of errors must be emailed in writing within 48 hours of the delivery request or the charges are considered accepted and any claims not made within the time specified is deemed waived. MD assumes no responsibility for the condition of the items being shipped. MD will not be liable for loss or damage caused by mis-delivery, non-delivery, delay of delivery, or improperly packed and /or labeled deliveries. Customer is responsible for any costs MD may incur in either returning a shipment or redirecting a shipment as well as any warehousing or storing a shipment pending a final delivery destination. Customer releases MD and its owners, employees, sub-contractors, and or agents from any liability and responsibility throughout the delivery process. Customer represents to MD that the contents of any shipments are not hazardous or illegal in nature. Customer agrees to payment terms and in the event the account becomes past due and the outstanding invoices are turned over to an attorney and or collection agency, the customer will pay for all attorney fees, court costs, and collection fees incurred in the attempt of collecting such amounts due. All work is subject to the Terms and Conditions above and are binding upon the parties hereto as well as their successors. All claims and actions must be brought in a court of competent jurisdiction within New York. MD is not obligated to act on any claim until the customer has paid all outstanding invoices and the customer may not deduct the amount of the claim from the outstanding invoices.* By checking here you are accepting the terms above. CAPTCHA