Credit Application Request

Business Details
Business/Trading Name*
Contact Name*
Prefix First Last
Email Address*
Enter Email Confirm Email
Phone Number*
Hidden
Website Address
Website Address
Business Status*
Other Business Status*
Company Reg Number
(if applicable)
VAT Reg Number
(if applicable)
EORI Number
(if applicable)
Collection Address*
This should be the address where we will be collecting goods from. If this varies, please note this in the collection window box further below on the form.

Street Address Address Line 2 City County Post Code Country
Is your invoice address different to your collection address?*
- No
- Yes
Invoice Address*
Street Address Address Line 2 City County Post Code Country
Where did you hear about us?*
Goods In Transit Insurance*
- Network Goods in Transit Insurance - RHA Conditions of Carriage (2020) (compulsary excess £75.00)
- Standard GIT & Storage Insurance - RHA Conditions of Carriage (2020) and RHA Conditions of Storage (2009)
- Additional Insurance
- Own Insurance
Value per Tonne required*
Credit Limit Request*
Frequency of Account Review with Account Manager*
Account Profile
Please complete the following section with as much detail as possible the profile stated below will form part of the three-month review process.
Operational Contact Name*
Operational Contact Email Address*
Customer Service Contact Name*
Customer Service Email Address*
Accounts Contact Name*
Accounts Email Address*
Average Pallets per Month*
Average Pallets per Consignment*
Average Weight per Pallet*
Type of product dispatched*
Business Hours*
Collection Window*
A time convenient for us to collect your consignments
Access Requirements
Any access requirements for us entering the business
Do you send pallets to Europe?
Do you have any storage or warehousing requirements?
Emergency Contact Details
Emergency Contact Name*
Prefix First Last
Emergency Contact Phone No.*
Emergency E-Mail Address*
Enter Email Confirm Email
Contractual Term and Pricing Policy
All prices will be held for a period of 12 months from the date of signing, subject only to changes in Government Legislation and fiscal policies.
All prices are subject to VAT and the companies fuel surcharge (a copy of which is available upon request).
The company reserves the right to add interest at 8% above the Bank of England’s base rate for any invoices not paid within our standard credit terms.
Signature Name*
Signature Title*
Signature Date*
MM slash DD slash YYYY
Terms and Conditions*
- I agree that the signature will be the electronic representation of my signature for all purposes when I (or my agent) use them on documents, including legally binding documents, just the same as pen-and-paper signature
Terms and Conditions*
- I agree to the standard C&D South West Ltd Terms & Conditions and the attached Terms of Storage and Terms of Carriage
Comments
This field is for validation purposes and should be left unchanged.

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01460 647 01

[email protected]

Credit Application Request

Business Details

Account Profile

Emergency Contact Details

Contractual Term and Pricing Policy

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in Delivery Tracking

Qualifications & Accreditations

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Contact Details

C & D South West Limited

[email protected]

01460 647 01

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Business Details

Account Profile

Emergency Contact Details

Contractual Term and Pricing Policy

Guaranteed On Time & Backed by the Latest Technology in Delivery Tracking

Qualifications & Accreditations

Pin It on Pinterest

Guaranteed On Time & Backed by the Latest Technology
in Delivery Tracking