Credit Application
Legal Business Name
________________________________________________________________________
Business Address ________________________________________________________________________
City ____________________________ Province _____________________ Postal Code ________________
Business Telephone ( ) _________________ Fax Number ( ) _________________
PST Exempt Exemption No. ______________________ PO No. Required __________
Business Principals 1. _________________ Title__________________2. _______________Title ___________
Type of Business ______________________________________________________________________
Number of Years in Business ____________ Amount of Credit Requested _______________________
TRADE REFERENCES (Please do not use Oil Companies as References)
1. _______________________________________ Phone ( ) ____________ Fax ( ) ___________
2. _______________________________________ Phone ( ) ____________ Fax ( ) ___________
3. _____________________________________ __Phone ( ) ____________ Fax ( )
___________ * must have fax number
BANK REFERENCES
1. _________________________________________________Phone ( ) _________ Fax ( ) ________
Bank and Contact Name
LIST OF MACHINERY AND EQUIPMENT
__________________________________________________________________________________________
I (we) agree to pay service charge of 2 % per month 24% per annum on all invoices older than 30 days. Failure to
pay invoices and/or service charges will result in the suspension of the privileges of a credit account with Pollard
Equipment (Chilliwack) Ltd
I (we) authorize Pollard Equipment (Chilliwack) Ltd to obtain such credit reports or other information which may be
deemed necessary in connection with the establishment and maintenance of a credit account. All information
submitted to Pollard Equipment (Chilliwack) Ltd will be held in strict confidence.
Signed _________________________ Position ______________________ Date _________________________
PERSONAL GUARANTEE I, ________________________, the undersigned, in consideration of your granting
credit to the above Company, of which I am an officer or agent, DO PERSONALLY GUARANTEE payment of all
accounts of the said company. This is a continuing and irrevocable guarantee and shall not be affected by any
extensions of time for payment or other arrangements you may make with the Company, but shall only be
discharged by payment in full of all the Company’s accounts
Signed ___________________________________ Date _____________________________
________________________________________________________________________
Business Address ________________________________________________________________________
City ____________________________ Province _____________________ Postal Code ________________
Business Telephone ( ) _________________ Fax Number ( ) _________________
PST Exempt Exemption No. ______________________ PO No. Required __________
Business Principals 1. _________________ Title__________________2. _______________Title ___________
Type of Business ______________________________________________________________________
Number of Years in Business ____________ Amount of Credit Requested _______________________
TRADE REFERENCES (Please do not use Oil Companies as References)
1. _______________________________________ Phone ( ) ____________ Fax ( ) ___________
2. _______________________________________ Phone ( ) ____________ Fax ( ) ___________
3. _____________________________________ __Phone ( ) ____________ Fax ( )
___________ * must have fax number
BANK REFERENCES
1. _________________________________________________Phone ( ) _________ Fax ( ) ________
Bank and Contact Name
LIST OF MACHINERY AND EQUIPMENT
__________________________________________________________________________________________
I (we) agree to pay service charge of 2 % per month 24% per annum on all invoices older than 30 days. Failure to
pay invoices and/or service charges will result in the suspension of the privileges of a credit account with Pollard
Equipment (Chilliwack) Ltd
I (we) authorize Pollard Equipment (Chilliwack) Ltd to obtain such credit reports or other information which may be
deemed necessary in connection with the establishment and maintenance of a credit account. All information
submitted to Pollard Equipment (Chilliwack) Ltd will be held in strict confidence.
Signed _________________________ Position ______________________ Date _________________________
PERSONAL GUARANTEE I, ________________________, the undersigned, in consideration of your granting
credit to the above Company, of which I am an officer or agent, DO PERSONALLY GUARANTEE payment of all
accounts of the said company. This is a continuing and irrevocable guarantee and shall not be affected by any
extensions of time for payment or other arrangements you may make with the Company, but shall only be
discharged by payment in full of all the Company’s accounts
Signed ___________________________________ Date _____________________________
| POLLARD EQUIPMENT [CHILLIWACK] LTD. 44755 Yale Rd, Chilliwack BC V2R 4H3 Phone (604) 793-2287 | Fax (604) 793-2284 |