Account Holder Details

Full Name Of Organisation Or Individual *

Trading Name (If Different)

Address

House Number & Street Address *

City *

County *

Country *

Postal code *

Proof Of Address (e.g., Utility Bill) *

Previous Address (If Less Than 3 Years At Current Address)

Full Name *

Position *

Phone *

Email *

Business Structure Type *

If Other, Please Specify

Registration Number

Date Business Formed

Business Description *

If Other Please Specify

How Would You Like To Receive Your Invoices And Credit Notes? *

Have Any Of The DIrectors, Owners, Or Partners Of The Organisation Held Any Other Accounts With Us? *

No

Yes*

*If Yes, Please Provide The Account Name(s)

Credit Limit Requested *

Names & Addresses Of Directors/Owners/Partners

(1) Name *

(1) Date of Birth *

(1) Address *

(2) Name

(2) Date of Birth

(2) Address

(3) Name

(3) Date of Birth

(3) Address

Names And Addresses Of Two Trade References

(1) Company Name

(1) Credit Limit

(1) Reference Address

(1) Phone Number

(1) Email

(2) Company Name

(2) Credit Limit

(2) Reference Address

(2) Phone Number

(2) Email

Payments

Would You Like A Login For Our Website (To Access Invoices, Place Orders, View Products, Etc.)? *

Yes

No

Account Security

Do You Require Our Invoices To Quote A Purchase Order Number Or Reference? *

Yes

No

If Yes, Please Specify The Required Information (e.g., Site Reference, Job Number, Purchase Order Number, etc.).

Signatory 1

Signatory 2

Signatory 3

Signatory 4

Signatory 5

Signatory 6

Signatory 7

Signatory 8

Do You Require Additional Signatories? If Yes, Our Account Department Will Contact You.

Yes

Agreement

By completing this Credit Account Application you are confirming the following:

1) you have the requisite authority to apply for credit and act on behalf of the Customer;
2) the information supplied in this Credit Account Application is true and accurate;
3) you have read and accept the applicable Conditions of Sale of Coomers Limited (in particular, the conditions relating to Credit Accounts) on behalf of the Customer;
4) you agree and accept that any Account provided by Coomers Limited, and any and all orders placed and contracts made with Coomers Limited are conditional on and subject to the Conditions of Sale of Coomers Limited, which can be viewed at www.coomers.co.uk/business-conditions-of-sale
5) you agree and acknowledge that Coomers Limited may make enquiries of credit reference agencies and other third parties who may record those enquiries to process your Credit Account Application, that Coomers Limited may also disclose information about the conduct of your Credit Account to credit reference agencies and other third parties and that the information obtained from or provided to credit reference agencies or other third parties may also be used by Coomers Limited when assessing further applications by the Customer for credit terms and for debt collection, tracing and fraud prevention purposes.

By Checking This Box, I Am Signing As An Authorised Signatory Of The Customer *

I Agree

Date Of Signature *

Signed Above By *

Signatory Position *

Credit Guarantee

This is a legally binding guarantee; it should only be signed by a director / owner / partner / trustee of the organisation or a third party who is prepared to personally guarantee performance of the Customer’s obligations. Your signature confirms you have read and understood its nature and effect.

In consideration of Coomers Limited agreeing to supply goods and / or services and to grant a credit account to the Customer, I hereby unconditionally guarantee the due and punctual performance and discharge of all of the Customer’s obligations and, in particular, the due and punctual payment on demand of all sums now or subsequently payable to Coomers Limited by the Customer (whether under a Contract or otherwise), including any financial obligations arising from any increase in the Customer’s credit limit granted by Coomers Limited from time to time, and I agree to indemnify Coomers Limited, and keep it indemnified, against all losses it may incur through any failure by the Customer to perform or discharge such obligations. I acknowledge and accept that this guarantee and indemnity is a continuing guarantee and indemnity and shall remain in force until all the Customer’s obligations have been fully performed and discharged and, in particular, until all sums due and payable to the Coomers Limited have been paid (in cash or cleared funds) in full.

By Checking This Box, I Am Signing As A Guarantor

I Agree

Signed On

Signed By

Your Position

I agree to receive other communications from Coomers Timber & Building Supplies.

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By clicking submit below, you consent to allow Coomers Timber & Building Supplies to store and process the personal information submitted above to provide you the content requested. Coomers Timber & Building Supplies is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you.

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