Online Forms

All information is required unless marked optional.

Ship To / Delivery Information

Ship To / Delivery Name

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)


Bill To Information

Billing Name

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)

Purchase Order (PO#)


Contact Information

Contact Name

Email

Phone Number

FAX (optional)


Order Information

A minimum 72 hour lead time is necessary to schedule the shipment of bulk products.

A minimum 7-10 working days lead time is necessary for all packaged products.

Requested Ship / Delivery Date and Time

 
PickupDelivery

Carrier (if delivery)

Special Instructions (optional)


Product Information

Product 1:
Product 2:
Product 3:
Product 4:
Product 5:
Product 6:
Product 7:
Product 8:
Product 9:
Product 10:

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Your order will be submitted to our Order Processing department. A Mississippi Lime CSR will contact you soon.

All information is required unless marked optional.

Company Information

Business Name

Email

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)

Accounts Payable Manager

Federal ID or Social Security Number

CorporationPartnershipSole ProprietorshipLLCLimited Partnership

Division of (optional)

Subsidiary of (optional)

Date Business Started

Amount of Credit required for 30 day period:


Trade References

Trade #1 Name

Account Number (optional)

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)


Trade #2 Name

Account Number (optional)

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)


Trade #3 Name

Account Number (optional)

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)


Bank Reference

Bank Name

Account Number (optional)

Address

City

State / Province

Zip / Postal Code

Country

Phone Number

FAX (optional)

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Credit Policy

PAYMENT TERMS: As stated on invoice with approved credit, Cash in Advance without approved credit.

CREDIT TERMS: If credit is granted (I) (we) promise to pay all invoices when rendered. (I) (We) understand all invoices are payable within stated terms on invoice, after invoice date and agree to pay a service charge of 1 1/2% per month on (my) (our) past due account balance. In the event payment is not received and (my) (our) account is placed for collection, (I) (we) will pay all cost of collection. If legal action is required, (I) (we) will pay reasonable attorney’s fees and court costs resulting from such action. Past due accounts will be placed on hold for any future charges. The undersigned further agrees to immediately notify Mississippi Lime Company in writing by registered mail of any change in ownership or form of applicant’s business organization. The undersigned agrees to provide to creditor updated financial information on request, and to provide an annual financial statement to Mississippi Lime Company as a condition of the continuation of this extension of credit.

ARBITRATION: All controversies or claims arising out of or relating to this Credit Application or the goods or products or the contract between Mississippi Lime Company and you shall be settled by arbitration in accordance with the commercial arbitration rules of the American Arbitration Association. The parties may obtain discovery as provided in the Missouri civil court rules or any successor rules. The arbitration hearing shall be held in St. Louis, Missouri. The award shall be final, and judgment thereon may be entered in any court, state or federal, having jurisdiction. The arbitrator shall have no power to impose punitive or exemplary damages. The arbitrator shall apply Missouri law in rendering any decision.

GOVERNING LAWS: The laws of the State of Missouri (without regard to its choice of law principles) shall govern the dealings between the parties, including the construction of these terms. The state and federal courts located within the Federal District for the Eastern District of the State of Missouri shall have the exclusive jurisdiction of any action between them, and you agree to submit to the jurisdiction of such court.

CERTIFICATION AND AUTHORIZATION TO RELEASE INFORMATION: I hereby certify the information in this credit application is correct. The information included in this application is for the use of Mississippi Lime Company in determining the amount and condition of credit to be extended. I understand that Mississippi Lime Company may also utilize other sources of credit information which it considers reliable in making this determination. Further, I hereby authorize the bank and supplier references listed in the credit application to release the information necessary to assist Mississippi Lime Company in establishing a line of credit, or updating my existing file.

Please allow 2 weeks to process sample requests. If you have any questions regarding your sample request after submission, feel free to contact sample@mlc.com.

*All fields are required.

Requestor Information

Business Name

Contact Name

Work Number

Email


Receiver Information

Is the Receiver the same contact as the Requestor above?     Yes   No

Business Name

Contact name

Address

City

State / Province

Zip / Postal Code

Country


Select Products

Select Products for Samples
QuicklimeHydrated LimePrecipitated Calcium CarbonatePulverized QuicklimeGround Calcium Carbonate

Quicklime
Pebble Quicklime 2 inPebble Quicklime 1 inPebble Quicklime 1/2 inGranular Quicklime

Hydrated Lime
Standard HydrateHydrate SPHydrate FGTActivated HydrateHydrate HRLiquid Calcium Hydroxide 38% solidsMicroCal HFMicroCal HFT20MicroCal HSMicroCal HXPPetroCal HFPetroCal HSVitaCal HVitaCal LCHPetroCal HStoverCal H

Precipitated Calcium Carbonate
Magnum Gloss 72% SlurryMagnum Gloss SATMagnum Gloss SD PCCMagnum Gloss XFMagnum Fill 65% PCCMagnum Fill 70% PCCMagnum Fill SDMagnum Fill MMagnum Fill SDLMagnum Fill HO97VitaCal PCC

Pulverized Quicklime
Pulverized Quicklime FTMicroCal OF 100MicroCal OF 200MicroCal OF 325MicroCal OFT15MicroCal OXPPolyCal OF 325PolyCal OS 325PolyCal OFT15VitaCal OPetroCal OF 100PetroCal OS 100

Ground Calcium Carbonate
CalCarb R1CalCarb R2CalCarb Mineral FillerCalCarb Coal Mine Rock DustCalCarb Athletic Field MarkerCalCarb Ag Stone A1CalCarb Ag Stone A2CalCarb AC3CalCarb PG (Poultry Grit)FGD LimestoneFeed Grade Limestone

Requested Size - Quicklime: Pebble Quicklime 2 in

Requested Size - Quicklime: Pebble Quicklime 1 in

Requested Size - Quicklime: Pebble Quicklime 1/2 in

Requested Size - Quicklime: Granular Quicklime

Requested Size - Hydrated Lime: Standard Hydrate

Requested Size - Hydrated Lime: Hydrate SP

Requested Size - Hydrated Lime: Hydrate FGT

Requested Size - Hydrated Lime: Activated Hydrate

Requested Size - Hydrated Lime: Hydrate HR

Requested Size - Hydrated Lime: Liquid Calcium Hydroxide 38% Solids

Requested Size - Hydrated Lime: MicroCal HF

Requested Size - Hydrated Lime: MicroCal HFT20

Requested Size - Hydrated Lime: MicroCal HS

Requested Size - Hydrated Lime: MicroCal HXP

Requested Size - Hydrated Lime: PetroCal HF

Requested Size - Hydrated Lime: PetroCal HS

Requested Size - Hydrated Lime: VitaCal H

Requested Size - Hydrated Lime: VitaCal LCH

Requested Size - Hydrated Lime: PetroCal H

Requested Size - Hydrated Lime: StoverCal H

Requested Size - Precipitated Calcium Carbonate: Magnum Gloss 72% Slurry

Requested Size - Precipitated Calcium Carbonate: Magnum Gloss SAT

Requested Size - Precipitated Calcium Carbonate: Magnum Gloss SD PCC

Requested Size - Precipitated Calcium Carbonate: Magnum Gloss XF

Requested Size - Precipitated Calcium Carbonate: Magnum Fill 65% PCC

Requested Size - Precipitated Calcium Carbonate: Magnum Fill 70% PCC

Requested Size - Precipitated Calcium Carbonate: Magnum Fill SD

Requested Size - Precipitated Calcium Carbonate: Magnum Fill M

Requested Size - Precipitated Calcium Carbonate: Magnum Fill SDL

Requested Size - Precipitated Calcium Carbonate: Magnum Fill HO97

Requested Size - Precipitated Calcium Carbonate: VitaCal PCC

Requested Size - Pulverized Quicklime: Pulverized Quicklime FT

Requested Size - Pulverized Quicklime: MicroCal OF 100

Requested Size - Pulverized Quicklime: MicroCal OF 200

Requested Size - Pulverized Quicklime: MicroCal OF 325

Requested Size - Pulverized Quicklime: MicroCal OFT15

Requested Size - Pulverized Quicklime: MicroCal OXP

Requested Size - Pulverized Quicklime: PolyCal OF 325

Requested Size - Pulverized Quicklime: PolyCal OS 325

Requested Size - Pulverized Quicklime: PolyCal OFT15

Requested Size - Pulverized Quicklime: VitaCal O

Requested Size - Pulverized Quicklime: PetroCal OF 100

Requested Size - Pulverized Quicklime: PetroCal OS 100

Requested Size - Ground Calcium Carbonate: CalCarb R1

Requested Size - Ground Calcium Carbonate: CalCarb R2

Requested Size - Ground Calcium Carbonate: CalCarb Mineral Filler

Requested Size - Ground Calcium Carbonate: CalCarb Coal Mine Rock Dust

Requested Size - Ground Calcium Carbonate: CalCarb Athletic Field Marker

Requested Size - Ground Calcium Carbonate: CalCarb Ag Stone A1

Requested Size - Ground Calcium Carbonate: CalCarb Ag Stone A2

Requested Size - Ground Calcium Carbonate: CalCarb AC3

Requested Size - Ground Calcium Carbonate: CalCarb PG (Poultry Grit)

Requested Size - Ground Calcium Carbonate: FGD Limestone

Requested Size - Ground Calcium Carbonate: Feed Grade Limestone


Shipping Method and Billing

Shipping Company FedEx   UPS
(Calcium Oxide products can ship by Air (FedEx only) but with restrictions.)

Account Number

Is this a third-party shipping account? Yes   No

Please enter the owner's name or company name


Application and Comments

Application (Examples: cement additive, rubber compound filler, lubricant, etc.)

Comments (optional)

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If you have any questions regarding your sample request after submission, feel free to contact sample@mlc.com.

Thank you for your interest in Mississippi Lime Company. We appreciate the opportunity to review your company and products.

Please complete the following vendor questionnaire. Photos, catalogs, samples, and other information can be mailed to the address below or emailed to purchasing@mlc.com.

Purchasing Department
Mississippi Lime Company
16147 U.S. Highway 61
Ste. Genevieve, MO 63670

All fields are required unless marked optional.

Contact Name

Email

Work Number

Cell Number (optional)


Business Name

Address

City

State / Province

Zip / Postal Code

Country


Product Detail

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All fields are required.

Your Name

Your Email

Your Phone Number

Requested Certificate

Your Message

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