Fillable Westburne Credit Application 2016 11

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Westburne Credit Application 2016 11

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Country of origin: CANADA
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CREDIT APPLICATION
Please return application to your local branch. Phone and address can be found at
http://www.Westburne.ca/
A Business Profile
Firm Legal Name:
Trade Name:
Ship to Address:
City:
Province:
Postal Code:
Fax:
Cell:
If Bill to Name/Head Office is different, please complete this section
Bill to Name/ Address ( if different than ship to):
Bill to Address:
Province:
Postal Code:
Business and Contact Information
PST No:
HST/GST No:
Check if Exempt
(supply tax certificate)
Date Started
Nature of Business
# employees
Monthly Purchases
A/P Contact Name:
A/P Contact Tel.:
A/P Email:
Purchaser Name:
Purchaser Tel.:
Purchaser Email:
Payment Method EFT – Electronic Funds TRF Online / Telephone Other
Statement Required Yes No
GO GREEN Send invoices by Fax Email
Email Address:
B Partners – Officers of Business (Give Full Name and Home Address of Owners)
Sole Proprietorship Partnership Corporation
Name:
Title
Home Address / Tel.:
SIN
Name:
Title
Home Address / Tel.:
SIN
C Bank References
Name of Bank
Acct. No:
Tel.:
Fax:
Bank Address in Full:
D Trade References (Electrical Wholesale Preferred)
Name:
Tel.:
Fax:
Name:
Tel.:
Fax:
Name:
Tel.:
Fax:
E Terms and Conditions of All Sales on Credit
In consideration of being permitted to effect purchases on my (our) account(s) up to a credit limit which will be determined by Westburne, a Division of Rexel Canada
Electrical Inc. (hereinafter “Westburne”), at its sole discretion, I (we) as Customer agree to the following conditions:
I (we) shall pay all invoices in accordance with the terms stated on such invoices by Westburne. W estburne’s terms and conditions of all sales on credit shall prevail
notwi thsta ndi ng anything that may be stated to the contr ary o n the Customer’s order, rec ei pt, bill of lading or other d ocume n t provided by the Customer.
I (we) hereby agree to pay administration c harges of 2% per month (26.8% per annum) on the amount of any overdue balance in my (our) account(s) from the date such
balance(s) become(s) overdue. I (we) hereby agree to pay all costs of collection and/or legal fees, in the event such actions become ne cessary to recover the balance(s)
owed in my (our) account(s).
A Return Authorization must be obtained before goods may be returned for credit. Restocking charges will apply on all goods r eturned. Reference must also be made to
our original invoice number.
I (we) agree that every statement of account shall be deemed and treated as authorized and correct, unless a written notice t o the contrary is received within fifteen (15)
days from the date of such statement.
The Customer agrees that title to the goods supplied by Westburne shall remain the property of Westburne, until such goods have been paid in full by the Customer and
where applicable under provincial laws, Westburne shall have a continuing security interest or purchase money security interest , lien or hypothec in all such goods and
their proceeds to secure the performance by the Customer of all its obligation to Westburne. The customer waives its right to receive a copy of any Financing Statement
and Verification Statement.
All changes in my (our) c ompa ny’s str ucture a nd/or its ow ner s a nd shareholders will be immediatel y repor ted to Westburne, in writing.
I (we) hereby authorize W estburne to conduct or cause to be conducted, as required, credit investigations on myself (ourselves), my (our)company(ies) and any related
persons or Cie, also to disclose credit references to other creditors as requested, with regards to the credit line established and the history of payments on account.
Notice – Consent: Westburne understands the importance of protecting your privacy. By submitting your personal information to us, you agree that W estburne may collect,
use and disclose such information in accordance with the terms of its privacy policy, a copy of which is available online at (www.rexel.ca) or by contacting us at
cpo.cprp@rexel.ca or at our credit department.
I agree to receive e-mails from Westburne which contain news, updates and promotions pertaining to its products. I understand that I may withdraw this consent at any
time.
The Parties agree that this Credit Application and any document referenced herein or attached hereto shall be drafted in Engl ish. Les parties aux présentes ont convenu de rédige r
cette de man de d e crédit et tout docum ent s’y af férant en anglais.
Signed at Province of this day of 20
Signature of Authorized Person Print Name Title
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Westburne Credit Application 2016 11

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Completed 25 October 2021

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