In order to properly process this application you must:

  • Complete it in full
  • Print it
  • Sign the printed copy in appropriate areas
  • Fax printed copy to 519-695-2249 (attn: Terry Mizzen)
  • Press "send" button after faxing has been completed

PLEASE PRINT THIS APPLICATION AND FAX TO 519-695-2249
Confidential Information
Type of Business:
Registered Business Name:
Trade Name:
Phone #:
Address:
Billing Address:
Nature of Business:
How Long in Business:
How Long at Present Address:
Premises are:
 Owned Leased
Expiry Date of Lease:
Landlord's Name:
Amount of Credit Requested:
Accounts Payable Contact:
Phone #:
Limited Company

President's Name:
Date of Incorporation:
Officers Names:
Sole Proprietorship or Partnership
Your Name:
Date of Birth:
Home Address:
Home Phone #:
Social Insurance #:
Driver's License #:
Bank Information
Name of Bank:
Account #:
Branch Address:
Bank Phone #:
Bank Fax #:
Bank Rating if Applicable:
Account Type:
Other:
Trade References (with whom you have charge privileges): (
Name
Address
Phone #
Fax # (necessary!!!)
Credit Agreement

(Please read before signing and faxing)

In consideration of acceptance of this application, applicant may obtain our products subject to the following terms and conditions:

  1. The Applicant agrees to pay for all purchases charged to the account upon receipt of statement.
  2. The Applicant agrees that a Service Charge of 1 1/2% per month (19.56% per year, compounded monthly will be applied to all past due amounts. The applicant also agrees that this charge does not relieve the applicants obligation of paying for purchased when due.
  3. The Applicant agrees that charge account privileges may be cancelled at any without notice.
  4. The Applicant understands that this is a Credit Application and as such agrees to authorize inquires into the Applicants credit standing either by direct communication or through Credit Reporting Bureau. The Applicant states that the information contained in this application is true and valid and that the applicant has signing authority. It is also understood that if this application for credit is accepted, the applicant agrees to the credit terms as stated in this Agreement.
Applicant:
Title:
Signature:
 _____________________
Date:
Co-Applicant:
Title:
Signature:
 _____________________
Date:

Please Note: All credit information must be completed for this application to be considered.
       
Personal Guarantee

IN CONSIDERATION OF Member ("Harold Marcus") granting credit and/or supplying goods to ______________________ (the "Customer" the undersigned and each of them, if more than one, hereby jointly and severally guarantees payment to Harold Marcus of all debts and liabilities, present or future, direct or indirect, absolute or contingent, matured or not, at any time owing by the Customer to Harold Marcus or remaining unpaid by the Customer to Harold Marcus AND THE UNDERSIGNED and each of them, if more than one, hereby jointly and severally agrees with Harold Marcus as follows:

  1. In this guarantee the word "Guarantor" shall mean the undersigned and, if more than one guarantor, it shall mean each of them.
  2. This guarantee shall be a continuing guarantee of all the guaranteed liabilities and shall apply to and secure all ultimate balance due or remaining unpaid to Harold Marcus and this guarantee shall not be considered as wholly or partially satisfied by the payment of liquidation at any time of any sum money for the time being due or remaining unpaid to Harold Marcus.
  3. Harold Marcus shall not be bound to exhaust its recourse against the Customer or others or any securities or other guarantees it may at any time hold before being entitled to payment from the Guarantor.
  4. Upon default in payment of any sum owing by the Customer to Harold Marcus at any time, Harold Marcus may treat all guaranteed liabilities as due and payable and may forthwith collect from the Guarantor and the Guarantor shall forthwith pay to Harold Marcus the total amount guaranteed and may apply the sum so collected upon the Guaranteed liabilities.
  5. This guarantee shall be in addition to and not in substitution for any other guarantees or other securities which Harold Marcus may now or hereafter hold in respect of the guaranteed liabilities.
  6. Without prejudice to or in any way limiting or lessening the Guarantor's liability and without obtaining the consent of or giving notice to the Guarantor, Harold Marcus may discontinue, reduce, increase or otherwise vary the credit of the Customer, and may grant time, renewals, extensions, indulgences, releases and discharges to and accept compositions from or otherwise deal with the Customer.
  7. This guarantee embodies all the agreements between the parties hereto relative to the guarantee, assignment and postponement and none of the parties shall be bound by any representation of promise made by any person relative thereto which is not embodied herein; and it is specifically agreed that Harold Marcus shall not be bound by any representation or promise made by the Customer to the Guarantor.
  8. The undersigned hereby authorizes Harold Marcus to make inquiries and to credit reporting agencies in its consideration of this personal guarantee.

IN WITNESS WHEREOF the Guarantor has signed, sealed and delivered this
guarantee this day of 20

Witness Signature:
 _______________________
Guarantor:
 _____________________
Witness Signature:
 _______________________
Guarantor:
 _____________________
 
Please click the submit button only once. Thank you !
  
PLEASE PRINT THIS APPLICATION AND FAX TO 519-695-2249