Fillable Credit Application Form - Western Equipment (Page 2 of 4) in pdf

Credit Account Application

Company Name:

Company Address:

City:

Prov./State:

Postal Code:

Telephone: (

)

Fax: (

)

Email:

Website:

Business Type:

Proprietorship

Partnership

Corporation

Other, (Specify)

Owner(s) or Company Officers

Position / Title

Credit References:

Trade References: (Please give Company Name, Address, Phone, Fax and Contact.)

Bank Reference: (Please give Name, Address, Phone and Contact.)

Other Information: Purchase Order Required: Yes

Accepts invoices via fax: Yes

Credit Limit Requested:

P.S.T. Exemption #

Name and Title of Contact Person for Account Information:

The undersigned applicant hereby makes this application for credit to Western Equipment Limited (“WEL”) and/or any of its

divisions, subsidiaries or trade styles, and in making this application the undersigned agrees that all amounts are payable in accordance

with terms as outlined on each invoice, and if not paid in accordance with such terms are then delinquent. If credit availability is granted

by WEL, all decisions with respect to the extension or continuation of credit shall be at the sole discretion of WEL. WEL may terminate

any credit availability within its sole discretion. The undersigned applicant agrees to pay their account within terms of sale as stated upon

each invoice. If any amounts are not paid w ithin the agreed period, the undersigned applicant agrees to pay a service charge, on such

amounts, of two percent (2%) per month (24% per annum) or the maximum amount permitted by Ontario law.

If the undersigned applicant’s account is placed in the hands of an outside agency for collection, the undersigned agrees to pay

reasonable attorney fees and collection costs, even though legal proceedings are not filed. If legal proceedings are filed, the amount of

such reasonable attorney fees shall be fixed by the court in which the proceeding is filed, including any appeal therein.

The undersigned applicant agrees that this agreement shall be governed by and construed in accordance with the laws of the

Province of Ontario. Jurisdiction and venue with respect to any suit in connection with the Agreement shall reside in the Municipality of

Chatham-Kent, Province of Ontario.

The undersigned applicant is hereby advised that WEL intends to refer to a report from a credit reporting agency in connection

with the opening of a new account proposed to be entered into by the undersigned with WEL, and the undersigned consents to the

obtaining of such information from his present or any future employer, credit reporting agency, or any person as WEL may require at any

time in connection with any transaction entered into between the same. If the applicant listed is a limited or incorporated entity the person

signing this application hereby certifies that they have the legal authority to bind the applicant to the above listed conditions.

Signature:

Title:

Name:

Date:

*************************************************************************************************************************

FOR WESTERN EQUIPMENT LIMITED USE ONLY:

Sales Representative:

Sales Number:

Credit Approved:

Date:

Limit:

Account #

Code:

Credit Refused:

Date:

Reason:

Personal Guaranty: Yes

Comments:

Signed:

Title:

Letters, etc. Sent:

P.O. BOX 340, CHATHAM, ONTARIO N7M 5K4

HEAD OFFICE :

97 ST. CLAIR STREET, CHATHAM, ONTARIO N7L 3J1 / PHONE (519) 352-0530 / TOLL FRE E PHONE 1-888-352-0530

CUSTOMER SERVICE FAX (519) 354-4220 OR TOLL FREE FAX 1-888-354-4220 / CORPORATE FAX (519) 352-0532

WINDSOR BRANCH : 3235 ELECTRICITY DRIVE, UNIT A, WINDSOR, ONTARIO N8W 5J1 / PHONE (519) 945-4520 / FAX (519) 945-5552

Credit Application Form - Western Equipment Page 2

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