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Credit Application - Ross Landfill Site

Your Information

* First Name
* Last Name
* Email Address

Company Information

* Legal Name of Company
* Address* City/Town* Province* Country* Postal Code
* Business Phone
Business Fax
* Accounts Payable Contact
* Type of Business
* Number of Years in Business

Principles/Owners Information

* Name
* Title
* Owners Home Address
* Owners City/Province
* Owners Phone
Owners Fax

Acknowledgement & Acceptance

In order to establish credit with the Township of Whitewater Region, Cobden, Ontario, I/we hereby authorize the release of any pertinent information that is requested about my/our account. My company and I authorize the Township of Whitewater Region to make such credit investigations as the Township sees necessary, including contacting bank(s) listed herein and obtaining credit reports. My company and I authorize all bank(s) and credit reporting agencies to disclose to the Township of Whitewater Region any and all information concerning the financial and credit history of my company and myself.

Payment of Invoice Balance:
The customer agrees to pay all invoice balances within the terms of the invoices (NET 30 DAYS).

Interest on Account:
All past due accounts will be issued a late charge at the rate of 1.25% per month compounded.

Default of Payment:
The Township will follow collection practices laid out in their Accounts Receivable policy for any past due amounts.

Denial of Further Credit and/or Service:
If past due invoices remain unpaid; the Township may deny any further goods or services being placed on the account. Only cash, certified cheque, money order and/or online payments will be accepted until the account becomes current.

Recovery of Arrears through Monies Owed to Customer:
If money is owing to the customer, these amounts will be applied to the customer’s general accounts receivable arrears, with notification to the customer.

In the event that an account is placed with a lawyer or a collection agency, any fees incurred in the collection process will be added to the account balance along with principle and interest.

* I/we hereby authorize the release of any pertinent information

* I certify that the information set out in this credit application is true and correct

* I acknowledge and accept the Township of Whitewater Region’s policies and practices