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Credit application request
*Required fields
 
Date:
 
General informations
    *E-Mail
*Registered corporate name
Trade name
(if applicable)
*Address
*City *Postal code
*Telephone Fax
*Owner's name
*Buyer's name
Accounts payable
Field of activity
Years in business Number of employees
*Monthly statement required
 
Bank informations
*Bank name
*Branch
*Telephone Fax
*Manager's account   *Account number
 
Delivery instructions
Delivery address if other than invoicing address
*Deliveries hours from to
Special instructions
(unloading: capacity, fork lift, overhead crane or other)
 
Trade references
Steel suppliers prefered
Name Acc.#
Address
TelFax


Name2 Acc.#2
Address2
Tel2Fax2
 
Authorization
We hereby give you authorization to supply all pertinent informations that will allow
Acier Rive-Nord Inc. to grant the credit necessary for good commercial relations.
 
Sales conditions

All material shipped remains the property of Acier Rive-Nord Inc. until full payment. Payment required 30 days following delivery date. Monthly interest of 2% (24% year) will be charged on any past due amount. Should we have to give your account to a third party (credit bureau and/or lawer) for no payment, the collection fees (20% of total debt) will be charged .
 
*Name *Title
Printed (AUTHORISED OFFICIAL ONLY)
 
 
Signature  
Guarantee
*I, undersign, guarantee conjointly with the company I represent, to execute each and all obligations ,present and futur, in wich the company is involved .
 
 
Signature Date  
 
Witness Date  
 
*Security Code. Please enter the Security Code exactly as shown in image format.  
   
 
480, boul. Industriel, Saint-Eustache (Québec) J7R 5V3
Tel.: (450) 974-3465, Free (514) 990-2998, Fax: (450) 974-3133




Our mission : To offer products and services of high quality
in order to exceed the requirements of our customers.

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© Acier Rive-Nord 2006