COMMERCIAL CREDIT - APPLICATION
BULK FUEL DELIVERY, CARDLOCK, MARINE OR AVIATION CREDIT



1. CONTACT INFORMATION*Mandatory fields to be completed.
* APPLICANT (Legal name of company or individual)
 
* OPERATING NAME (Doing business as)
 
* TYPE OF BUSINESS
 
* YEARS IN BUSINESS
 
* MAILING ADDRESS* CITY* PROV
    
* POSTAL CODE
 
CURRENT FUEL/LUBRICANTS SUPPLIER
* E-MAIL ADDRESS
 
* PHONE
 
FAX
* CELL
 
* ACCOUNTS PAYABLE CONTACT NAME
 
* ACCOUNTS PAYABLE DIRECT PHONE #
 


2. NAME OF PROPRIETOR OR PRINCIPALS OF COMPANY
* NAME
 
* HOME ADDRESS
 
 * HOME PHONE
 
POSITION/TITLE
 
SIN Optional
* DATE OF BIRTH
 
NAME
HOME ADDRESS
HOME PHONE
POSITION/TITLE
SIN Optional
DATE OF BIRTH


3. CREDIT REFERENCES and ADDITIONAL BANKING INFORMATION
* COMPANY NAME
 
* CONTACT NAME
 
* TEL#
 
COMPANY NAME
CONTACT NAME
TEL#
* BANK
 
* BRANCH NAME/LOCATION
 
HOW LONG
 


4. PAYMENT METHOD





5. SPECIAL INSTRUCTIONS (if applicable)
TAX EXEMPTION ON FUELS Please provide applicable tax exempt number below and send details of exemption claim on company letterhead
PST #
GST #
COMMERCIAL FISHING #
FARMER #
Native Exemption Status #
OTHER


6. PERSONAL GUARANTEE
The process of granting credit often requires a Personal Guarantee for credit approval. – Please check one.
Personal Guarantee Name


7. PRODUCTS & SERVICES
Cardlock - We offer an extensive cardlock network on that is accessible 24 hours a day on Vancouver Island with mainland cardlocks soon to be integrated into our system.

Bulk Fuel Delivery - We deliver a wide selection of products to customer in the Forestry, Transportation, Marina and Construction Industries. Typical bulk fuel deliveries are made to tanks, generators and industrial equipment.

Select Fuel Service Delivery - This is a scheduled fuel delivery service to equipment/vehicles at your job site. Important Note: Select Service Fuel Delivery requires a minimum of 5 units per delivery address and an average of 100L per unite unit per scheduled delivery.

Aviation - We offer delivery of aviation products.

Marine - We offer marine fuel delivery to commercial vessels.

Lubricants - We have a full range of bulk and packaged lubricants available for pick-up or on-site delivery.



Form 438

**For all marked product, a completed Form 438 must be turned in with accompany the completed credit application.
All products are subject to site availability

















Columbia Fuels Terms of Service

To purchase goods and services on an account with Columbia Fuels – A Division of Parkland Industries Ltd. (the “Supplier”), the Applicant agrees to the following terms and conditions.

1. The Applicant agrees and consents to the Supplier making credit inquiries about the Applicant and/or the Undersigned in connection with this credit application, for any future renewal or extension of credit, or as deemed necessary from time to time.

2. The Applicant acknowledges that the Supplier may require a personal guarantee by an individual satisfactory to the Supplier.

3. The Applicant will pay the Supplier the total amount set out in each invoice, which is due and owing to the Supplier within 30 days of invoice date or other terms as granted by the Credit Department in writing.

4. The Applicant acknowledges that all payments shall be made to Columbia Fuels – A Division of Parkland Industries Ltd’s corporate office located at 2669 Wilfert Rd., Victoria B.C., V9B 5Z3.

5. The Applicant agrees to pay a service charge of 2% per month (26.8% per year nominal) compounded monthly and to be calculated as per the Canada Interest Act on past due balances. Any credit balance less the $5.00 at the time of cancellation of the account will not be refunded to the Applicant.

6. The Applicant agrees to pay the Supplier all charges, service charges, taxes, return payment fees accessed and all other amounts incurred for the delivered product or other purchases and services to the account. The Applicant also agrees to pay for all charges incurred by the applicant’s cardlock cards as a consequence of the use of the Supplier’s card lock facilities by any person, whether authorized by the Applicant or not.

7. All commercial product pricing may at any time be increased or decreased at the sole discretion of the Supplier. The Applicant waives any right to advance notice of any change in price

8. The Applicant agrees to provide the Supplier fourteen (14) days notice in writing of the Applicant’s intention to cancel the account.

9. Provided that, if this is to be a joint account, the Applicants hereby jointly agree to pay this account in accordance with the terms and conditions of this agreement.

10. The Applicant hereby agrees that nothing herein shall bind or compel the Supplier to advance or re-advance credit to the Applicant and further, the Supplier may alter the credit limit and/or terms or even suspend credit privileges as deemed appropriate by the Supplier from time to time.

11. The Applicant agrees to advise the Supplier immediately of any change of the information contained in the account application.

12. The Supplier shall not be liable for failure to supply delivered fuel or lubricants if prevented by Acts of God, fire, labour disturbances, impassable roads, shortage of fuel or lubricants or any other causes reasonably beyond the Supplier’s control.

13. If upon audit of any delivery ticket or invoice an error is detected in the calculation or applicable taxes charged, the Supplier will make the required correction and the Applicant agrees to pay the corrected amount.

14. If the account is sent to a third party collection agency and collection action is initiated, the Applicant agrees that an administration fee of $250.00 will be charged to the Applicant’s account. In addition, the Applicant agrees to pay all reasonable collection costs.

15. This contract is deemed to be made in Victoria, British Columbia and any breach of this contract may at the discretion of the Supplier, be litigated in any court in the Greater Victoria Electoral District in the province of British Columbia.

16. The Applicant agrees that any contact number provided on the application or through other means after the account is established can be used to secure payments on the account.

17. The Supplier shall not, at any time, sell customer lists to any company or organization not affiliated with Columbia Fuels – A Division of Parkland Industries Ltd. For further information on our Privacy Policy, please visit our website at www.columbiafuels.com . If you require a hard copy; please forward your request in writing.

18. Acceptance of any amendment or alteration of this agreement must be confirmed in writing by the Supplier to the Applicant.

The undersigned agrees to these terms and conditions.

In witness whereof the Applicant(s) hereto have executed these presents this 23, of April 2014

By clicking on 'I accept' below you are agreeing to the Terms of Service above.