COMMERCIAL CREDIT APPLICATION FORM
– CANADIAN BUSINESSES -
BUSINESS INFORMATION
Requested Credit Limit: Sales Representative:
Legal Business Name: Trade Name (if different):
Business Type (circle one): Corporation Partnership Proprietorship
Date of Registration (mm/dd/yyyy): How long in business (years):
Type of Business:
Business Address:
Street Address City/Town Prov Postal Code
Business Phone: Business Email:
Business Fax: Accounts Payable Contact Name:
Account Payable Phone: Account Payable Fax:
PRINCIPALS/OWNERS OF BUSINESS
Name of Principal/Owner #1:
Residential Address:
Cell Phone Number:
Name of Principal/Owner #2:
Residential Address:
Cell Phone Number:
BANK REFERENCE
Bank Name: Address:
Account #: Contact Name: Phone #:
TRADE REFERENCES
Please provide 3 references (mandatory)
Name: Address:
Phone #: Fax #:
Name: Address:
Phone #: Fax #:
Name: Address:
Phone #: Fax #:
CREDIT REQUESTED FOR WHICH OF THE WALKER COMPANIES/DIVISIONS (check all that apply):
Walker Aggregates Inc. (Niagara) Walker Emulsions Limited
Walker Aggregates Inc. (Essex) Walker Environmental Group Inc.
Walker Aggregates Inc. (Simcoe) Woodington Systems Inc.
Norjohn Contracting and Paving Limited All Treat Farms Limited
TERMS AND CONDITIONS
Upon acceptance of this application, the customer may purchase goods on credit, up to the limit set by Walker Industries and/or any
of its subsidiaries on the following terms and conditions.
a. Invoiced amounts shall be paid within 30 days of the date of the invoice (the “Due Date”)
b. Interest on any unpaid invoiced amount will be charged from the date of payment at 2% per month (26.8%per annum.)
c. The customer agrees that all accounts shall be paid in accordance with the Terms and Conditions set out above and the
customer acknowledges and agrees that Walker Industries and/or any of its subsidiaries reserve the right to withhold,
cancel or modify credit privileges at its discretion.
d. Walker Industries and/or any of its subsidiaries may at any time obtain credit information about the customer from any
credit bureau, credit reporting agency and to person with who the customer has or proposes to have financial dealings or if
Walker Industries and/or any subsidiaries believe disclosure is required by law.
Notice: A consumer report may be referred to in clearing your application and if the customer is a corporation, a consumer report of
the directs, officers or owners of the corporation may also be referred to. The customer consents to the obtaining of such
information as Walker Industries and/or subsidiaries require in connection with the credit appliled for or any renewal or extension
thereof.
I have read and agree to the terms and conditions as stated above.
I, the undersigned, agree to the above terms and conditions, declare that all the information supplied in this credit application is true
and accurate, that I am authorized to request a charge account at Walker Industries and/or any of its subsidiaries. Furthermore, all
bank and trade references indicated are authorized to provide information as may be requested from time to time by the seller or its
agent.
Name (please print) Signature:
Company Name (please print) Title (please print)
Date (mm/dd/yyyy):
