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Corporate Name
Trade Name
  Corporation Proprietorship Partnership
Date Established (dd/mm/yy)


Billing Address  
 
City
Province
Postal Code
Work Telephone
Fax
E-mail


    List of Officers (Corporations Only)
President
Treasurer
Accounts Payable


P.S.T. Number  
G.S.T. Number
   
  Are Purchase Orders Required?
Yes      No
   
Contact Name


   

Credit References

Reference #1
Name
Address
 
City
Province
Postal Code
Telephone
Fax
 
Reference #2
Name
Address
 
City
Province
Postal Code
Telephone
Fax
 
Reference #3
Name
Address
 
City
Province
Postal Code
Telephone
Fax
 
Bank Reference
Bank
Contact
Telephone


  Declaration
The information given is warranted to be true and given for the purpose of obtaining credit and in the event credit is given, I/We agree to abide by your terms of sale. I/We agree to pay service charges on overdue accounts at the rate shown on your invoice terms.
 
Date (dd/mm/yy)
Name
Position


    Terms
Payment terms are net 30 days.
 
B&C Truck Centre - 639 Main Street West, Port Colborne, Ontario
24 Hour Emergency Service - 1.888.407.1269 || Service - 905.835.1632
Parts - 905.835.9351 || info@bctruck.ca
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