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I authorize Central Supply Inc to charge the credit card indicated in this  authorization form/Payment Site according to the terms outlined  above/& or in my contract/Invoice. This payment authorization is for  the goods/services described above/ or corresponding to the Invoice,  for the amount indicated above only, and is valid for one (1) time use  only. 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, without  first making a good faith effort to remedy the situation directly with  Central Supply Inc , so long as the transaction corresponds to the terms  indicated in this form.

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