CRITICAL IMPACT LIMITED CREDIT
ACCOUNT APPLICATION
Please
complete all sections, sign and return by Fax to 0207 843 6721 or Post to
Critical Impact Limited
Form completed
by: …….…………….…………….…………….………………….
Phone:
…….…………….…………….…………….…………………………………
Email:
…….…………….…………….…………….………………………………….
Full Company Name:
…….…………….…………….…………….………………..
Invoice address inc. Post Code:
…….…………….…………….…………….……
….…………….…………….…………….…………………………………………….
….…………….…………….…………….…………………………………………….
….…………….…………….…………….…………………………………………….
Company Registration No:
…….…………….…………….…………….………….
Telephone No:
…….…………….…………….…………….………………………..
Fax No:
…….…………….…………….…………….………………………………..
Are Critical Impact to accept your
Purchase Orders via email YES / NO
Any
disclaimer held within emailed
Please
indicate whether you would prefer to receive invoices/statements via email
(please give Email address) or post & where to if different from
above.
Contact
Details;
Financial Director:
…….…………….…………….…………….……………………
Phone:
…….…………….…………….…………….…………………………………
Email:
…….…………….…………….…………….………………………………….
Purchase Accts Manager:
….…………….…………….…………….……………..
Phone:
…….…………….…………….…………….…………………………………
Email:
…….…………….…………….…………….…………………….……………
The
applicant accepts, if credit is granted, that all goods and services will be
supplied under our standard terms and conditions of sale
including:
a) Payment
to be made within 28 days of invoice date
b) The
option to charge interest on overdue balances
c) Credit
may be stopped if account exceeds the agreed credit limit or falls into arrears,
and further action may be taken at our discretion
d) Title to
goods only passes upon full payment
Authorised Signature:
…….…………….…………….…………….………………
Position:
…….…………….…………….…………….………………………………
Name [print]:
…….…………….…………….…………….…………………………
Date: …….…………….…………….…………….…………………………..
Should you have any queries regarding
this form, please contact us on 0207 843
6810