I authorize WILLDAN to debit my account for the amount indicated above. I authorize WILLDAN to charge the credit
card indicated above. This payment is for the goods and services described in my Work Order Agreement for the amount
indicated above only and is valid for one (1) time use only but does not represent all outstanding balance owed on my
Work Order Agreement. I certify that I am an authorized user of this credit card and that I will not dispute the
payment with my credit card company so long as the transaction corresponds to the terms indicated in this form.
If enrolled in an installment payment plan, I understand and authorize regularly scheduled charges to my credit card.
I agree to the amount charged indicated above each billing period. A receipt for each payment will be provided to me
and the charge will appear on my credit card statement. I agree that no prior notification will be provided unless
the date or amount changes, in which case I will receive notice from Willdan at least 10-days prior to the payment
being collected.
I understand this authorization will remain in effect until I cancel it in writing, and I agree to notify Willdan
in writing of any changes in my account information or termination of this authorization at least 15-days prior to
the next billing date. If the payment date falls on a weekend or holiday, I understand that the payments may be
executed on the next business day. I certify that I am an authorized user of this Credit Card and will not dispute
these scheduled transactions so long as the transactions correspond to the terms indicated in this authorization.
If Willdan is required to take legal action to collect monies owed under this Agreement, I agree to pay Willdan’s
expenses, including attorney’s fees, incurred in its collection efforts. I agree to immediately notify Willdan upon
discovering the credit card has been misused as a result of this authorization.
