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Become a Customer at Raven Supply
Please fill out the below and contact us if you have any issues or questions!
Application for Purchases & Credit at Raven Hydronic Supply Ltd.
The undersigned company is applying to make purchases at Raven Hydronic Supply Ltd and agrees to abide by the account terms and conditions of Raven Hydronic Supply Ltd as listed below.
Company Name
(Required)
DBA (if different)
Contact Person
(Required)
Title
Name
Email
(Required)
Accounts Payable Contact (if different from above)
Name
Email
Company Billing Address
(Required)
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Business Phone Number
(Required)
Type of Business
Website
Date of Business Established
Month
Day
Year
Number of Employees
1-4
5-10
10-20
30-60
60-100+
Are you a (pick one)
(Required)
Corporation
Partnership
Sole Proprietorship
Province of Incorporation
Corporate Officers
(Required)
Name
Title
Email
Add
Remove
Select the "+" for more entries.
Names and Addresses of the Partners
(Required)
Name
Address
Add
Remove
Click the "+" to the right for more fields.
Are you sales tax exempt?
(Required)
Yes
No
PST # (blank if exeption letter attached below)
Tax Exemption Letter (optional)
Max. file size: 32 MB.
Have you ever had credit with us before?
Yes
No
Under what name have you had credit with us before?
Do you want to apply for credit?
Yes
No
Trade References (Please submit at least 3 references)
(Required)
Reference Name
Address
Phone Number
Email Address
Add
Remove
Select the "+" for more entries.
Bank Reference
(Required)
Account #
Phone
Contact Person
Name of Bank
Address
Account Terms & Conditions
(1.) Customers who do not have an existing account are required to make payment for their first order in advance, either through a deposit or full payment. Submitting a credit application does not wave this requirement. (2.) Once your credit application is approved, customers are generally offered Net 30 Days purchase terms. (3.) A service charge of 2% per month will be added to all overdue invoices. (4.) No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.
Consent
(Required)
I represent that the above information is true and if applied for credit, given to induce Raven Hydronic Supply Ltd to extend credit to the applicant.
I have read the terms and conditions stated above and agree to all of these terms and conditions. (If applied) My company and I authorize Raven Hydronic Supply Ltd to make such credit investigation as Raven Hydronic Supply sees fit, including contacting the above trade references, bank, and credit reporting agencies to disclose to Raven Hydronic Supply Ltd any and all information concerning the financial and credit history of my company and myself.
Authorizer's Information
(Required)
Print Name
Title
Date Signed
Your Comments/Questions
Comments
This field is for validation purposes and should be left unchanged.
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