Create New Global Medical Innovations Account

BY COMPLETING AND RETURNING THIS APPLICATION GLOBAL MEDICAL INNOVATIONS, THE APPLICANT REPRESENTS THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION ARE TRUE AND CORRECT AND APPLICANT AGREES THAT IF ANY OF THE INFORMATION BECOMES OUTDATED OR IF APPLICANT LEARNS OF A POSSIBLE OR PENDING CHANGE IN OWNERSHIP OR MANAGEMENT OF IT OR ANY FACILITY, IT WILL IMMEDIATELY NOTIFY GLOBAL MEDICAL INNOVATIONS. THE APPLICANT FURTHER AGREES THIS AGREEMENT SHALL BIND APPLICANT’S HEIRS, PERSONAL REPRESENTATIVES, SUCCESSORS AND ASSIGNS AND INURE TO THE BENEFIT OF GLOBAL MEDICAL INNOVATIONS.

THE UNDERSIGNED OR APPLICANT IDENTIFIED AS PROPRIETOR, OWNER, AND OR MAJORITY SHAREHOLDER, AUTHORIZES MEDLINE OR ITS SUBSIDIARIES TO VERIFY THIS INFORMATION BY OBTAINING DATA FROM A CREDIT REPORTING AGENCY. THE UNDERSIGNED ACKNOWLEDGES THAT HIS OR HER INDIVIDUAL CREDIT HISTORY MAY BE A FACTOR IN THE EVALUATION OF THE CREDIT HISTORY OF THE APPLICANT AND HEREBY CONSENTS AND AUTHORIZES THE USE OF A CONSUMER REPORT ON THE UNDERSIGNED BY GLOBAL MEDICAL INNOVATIONS OR ITS SUBSIDIARIES FROM TIME TO TIME, AS MEDLINE OR ITS SUBSIDIARIES MAY DEEM NECESSARY IN ITS CREDIT EVALUATION.