APPLICATION FOR COMMERCIAL CREDIT ACCOUNT

PRESTIGE BRICK AND STONE INC.

Step 1: Accurately respond to all the questions listed in this Application For Commercial Credit Account.
Step 2: Print this webpage by clicking the Print Application For Commercial Credit Account button.
Step 3: Call Andy Derix at 613.930.9001 to submit the completed Application For Commercial Credit Account.
Customer Name:
Address:
Telephone No.: Fax No.:
Social Insurance No.: Date of Birth:
Accounting Contact: Credit Limit Requested:
P.S.T. No.: Use Purchase Order?

If Applying for Company, Partnership, or Proprietorship Account, List ALL PRINCIPAL(s) Below:

Principal Name: Principal Phone No.:
Principal Name: Principal Phone No.:
Principal Name: Principal Phone No.:
Principal Name: Principal Phone No.:

List Supplier Credit References including Banking Information:

Bank: Branch: Account No.:
Telephone No.: Contact:
Supplier - 1:
Address:
Telephone No.: Fax No.: Contact:
Supplier - 2:
Address:
Telephone No.: Fax No.: Contact:
Supplier - 3:
Address:
Telephone No.: Fax No.: Contact:

CREDIT POLICY

Credit will only be extended after a detailed credit check is completed. All information supplied will adhere to the Privacy Act as currently inscribed in the province of Ontario.

On approval of credit, a credit limit will be established by the Credit Department and the Sales Representative. Orders received when the customer is over their credit limit will be accepted solely at the discretion of the Credit Department.

All credit privileges are automatically terminated with the receipt of an N.S.F. cheque. Credit privileges will be withheld until satisfactory arrangements are made regarding the full outstanding balance.

Accounts where payment has not been received within 30 days of statement date will be subject to cancellation without further notice and all orders will be handled C.O.D. only, or solely at the discretion of the Credit Department.

Unidentified and Lump-sum payments will apply to the oldest invoices or charges in the account unless specifically directed at the time payment is made.

Materials returned for credit will be subject to the standard inspection and are subject to a minimum restocking charge of 20%. Cartage “outbound” or “inbound” on goods returned is not refundable.

I agree to pay account balance within 30 days of statement date, and will accept carrying charges of 2% per month (24% per annum) on any balance due over this 30 days period. I hereby authorize the firm to whom this application is submitted to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of an account or for any other direct business reason.

I also agree to pay the Supplier all losses, costs, expenses, and fees arising from, or related to, purchases made on this account and efforts to collect payment for those purchases.

We have read and understand your terms of credit as indicated above and agree to abide by them. We also understand that we are PERSONALLY responsible and liable for payment of all goods supplied by, or on behalf of, Prestige Brick and Stone Inc.

Principal's Name: Signature: Date:
Please Print




Principal's Name: Signature: Date:
Please Print




Principal's Name: Signature: Date:
Please Print





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OFFICE USE ONLY

Credit Limit Granted: Sales Representative:
Approved By: Rejected By:
Account No.: Date Account Opened:
Notes / Comments: