Your name (required) Your cell (required)
Company Name (required) Phone (required) E-Mail (required) Type of commerce (required) In business since (required)
Person in charge of purchases (required) Cell (required)
Billing address (required) City (required) Postal Code (required) Tax numbers - GST (required) Tax numbers - QST (si applicable)
Name of person responsible for accounts payable (required) Email (required)Our company prioritizes the sending of account statements by electronic mail Address if by mail (if different from place of business)Account statements are only sent if the balance exceeds $25.00 Purchase order required? (required) ---YesNo COD or Account with credit? (required) ---CODCredit
Financial Institution (required) Phone (required) Contact (required) Account Number (required) Transit Number (required) PLEASE NOTE THAT WE ARE REGISTERED WITH THE FOLLOWING BANKING INSTITUTIONS FOR DIRECT DEPOSIT. COMMUNICATE WITH THE PERSON RESPONSIBLE FOR CUSTOMER ACCOUNTS.
Reference #1 - Name (required) Reference #1 - Phone (required) Reference #1 - E-mail (required) Reference #2 - Name (required) Reference #2 - Phone (required) Reference #2 - E-mail (required) Reference #3 - Name (required) Reference #3 - Phone (required) Reference #3 - E-mail (required)
The Company and I authorise Les Pièces Hydrauliques Ménard Inc. to verify any information in this application. I also authorise the other suppliers and the bank mentioned in the application to give to Les Pièces Hydrauliques Ménard Inc. the required information for the verification of our credit rating.
I accept the terms listed above and I am in my capacity for the company as well as individually as security and guarantor for the obligations of the company.