Download Our a Customer Credit Application Form

Please fill out and send to [email protected]

Vancouver Headquarters: 7185 11th Ave, Burnaby, BC, Canada, V3N-2M5 Calgary Terminal: 4216 61st Ave SE, Calgary, AB, Canada, T2C-1Z5 Edmonton Terminal: 12240 60 St NW, Edmonton, AB, Canada, T5W-5J6 Nanaimo Terminal: 125 Bowlsby Street, Nanaimo, BC, Canada, V9R-6Z8 Kelowna Terminal: 720 Evans Ct, Kelowna, BC, Canada, V1X-6G4 Burnaby Terminal: 2864 Norland Avenue, Burnaby, BC, Canada, V5B-3A6 Phone: 604.245.1911 | Fax: 604.245.1808 | Website: www.speedeetransport.com

CREDIT APPLICATION FORM

BUSINESS INFORMATION

Trade Name: ______

Phone: ______Fax: ______

Billing Address: ______City: ______Province: ______Postal Code: ______

GST Number: ______Are you GST Exempt?: Yes ____ No ____

ACCOUNT PAYABLE INFORMATION

A/P Contact: ______Email: ______

A/P Phone: Ext A/P Fax:______

How do you want to receive our Invoices: Email _____ Upload to website _____ Other ______

POD# required with invoice?: Yes ____ No____

Special Reference # required for A/P to process Payment: ______

Expected monthly freight revenue: ______

Expected monthly freight volume: ______

Credit Limit Request: ______

Payment Method:

EFT_____ Please send the payment remittance to [email protected]

E-transfer_____ Please make the e-transfer to [email protected]

Credit card______Please complete Credit Card Payment Authorization Form enclosed.

Cheque____ Please make cheque payable to SPEED EE TRUCKING LTD (we recommend electronic payments so there are no delays or lost cheques).

BUSINESS/TRADE REFERENCES

1. Company Name ______

Contact Name: ______

Email ______

Phone______

Fax______

2. Company Name ______

Contact Name: ______

Email ______

Phone______

Fax______

3. Company Name ______

Contact Name: ______

Email ______

Phone______

Fax______

------Terms and Conditions ------

Speedee Transport terms are full payment within 15 days of the date of the invoices. OAC Full terms and conditions can be found on the website at www.speedeetransport.com

------Undersigned Applicant Agreement ------

Agreement for SPEED EE TRUCKING LIMITED DBA Speedee Transport

I/We agree to pay all Speedee Transport, in full in consideration of extended credit per Speedee’s terms on www.speedeetransport.com

I/We understand and agree to pay any/all costs including 4% per month compounded monthly, on any overdue balance until paid.

I/We understand and agree to all legal and collection fees in addition to the amount owed plus the interest charges.

I/We have read and agreed to abide by the Speedee terms and conditions listed on www.speedeetransport.com.

I/We consent to the obtaining of bank/credit information as may be required at any time in connection with the credit hereby applied for or renewal or extension thereof and to the disclosure of credit information concerning me/us and or my/our company to any credit reporting agency or to any person with the undersigned who has or purports to have financial relations.

I/We hereby certify that the information contained in this application is true and correct.

Authorized Officer(s)

Signature: ______Title: ______

Print Name: ______Date: ______

Please email your application, SOP, and Rate sheet to: [email protected]

Speedee Account Representative or your contact at Speedee Transport: ______