Please fill in this form entirely before submitting.
Estimated Annual Purchases: Employer: Employer Address: Position: How Long:
Banking: Bank: Branch: Acct.#: Your Social Insurance Number: Spouses Social Insurance Number: Type of account you wish to be open: Cardlock 24 Hr. Fuel Pumps (Barrie-Orillia-Midland) Fuel - Delivered Ready Mix
Your Sales Representative: Bill Fligg Walter Marshall Doug Sutton John Mannerow Dale Dennis Scott Elliott Rob Fyles John Rumble
Terms and Conditions:
1. This is an Application and Agreement for credit and shall apply to any and all credit extended by The Sarjeant Co. Ltd.
2. Applicant has authority to enter this agreement. Person signing has been authorized to execute this agreement for applicant.
3. The information given is warranted to be true and given for the purpose of obtaining credit. The applicant consents to the obtaining of credit and/or personal information as may be required in connection with the credit line hereby applied for or any renewal or extension thereof and to the disclosure of any trade information concerning the undersigned to any credit reporting agency or to any person with whom the undersigned has or proposes to have financial relations.
4. In the event credit privileges are extended, I/we agree to abide by the terms of sale of The Sarjeant Co. Ltd. and conditions.
5. I/we agree to pay interest charges on overdue accounts at the rate of 2% per month, 24% per annum, as shown on your Invoice/Statements.
6. NSF cheques will be subject to a $15.00 charge.
7. The undersigned hereby agrees to pay all accounts when rendered. On default, the undersigned agrees that all lawyer's and/or agent's costs of recovering the debt are also payable.
8. Failure to comply with these Terms and Conditions may result in cancellation of credit privileges.
DO YOU AGREE WITH THE ABOVE TERMS AND CONDITIONS? Type "yes" to agree or this form will not be submitted (all lowercase)! Thank You