If you would like an account for fuel or lubricant purchases, please fill out the following Haukedal Ent. Inc. credit application. We will confirm your application as soon as possible thereafter. All fields marked with a * are mandatory.
   

 

 

  
 
COMPANY INFORMATION
Legal Business Name *
 Telephone Number *
Mailing Address *
 Fax Number *
City and Province *
 Postal Code *
Delivery Address (if different than mailing address)
Cell / Alternative Phone Number
    
Nature of Business *
 Years in Business *
Number of Employees *
    
Name of Principals *
Position *
SIN *
Date of Birth *

  

CREDIT INFORMATION
Credit References (where 30 day priveleges have been established)
  1. *
  2. *
  3. *
    
Bank Name *
Address *
Telephone Number *
 Account Manager *
    
Credit Limit Requested *
PO's Requested
Accounts Payable Contact *
    
TEFU Number (if applicable)
AFFDA Number (if applicable)

  

ACCOUNT AGREEMENT

In consideration of HAUKEDAL ENTERPRISES INC. and/or IMPERIAL OIL LIMITED and/or IMPERIAL OIL PRODUCTS DIVISION, hereinafter referred to as the “company” granting credit for the purpose of purchasing products and/or service, I/we agree to be bound by the following terms and conditions governing any and all such credit purchases namely:

  1. All purchases due 25 days from receipt of product and/or service.
  2. Any amount due and not paid by the end of the due date, shall be charged a service charge calculated at the rate of 2% per month, compounded monthly.  Effective annual rate is 26.82%.
  3. Company may vary the service charge rate by giving written notice by way of regular mail to the applicant not less than 60 days before the variation becomes effective.
  4. Any payment made in respect of a credit transaction shall be applied first to the accumulated service charge, and thereafter to the principle amount of the outstanding debt.
  5. Approved cardlock holders will be responsible for payment of all products registered and/or recorded on the cardlock meter, until the company receives written notice of its loss or theft to deactivate the card or cards.
  6. The applicant agrees that the company and/or its authorized agent may access personal credit bureau reports and/or credit reports containing information in connection with the applicant, and I/we authorize the receipt and exchange of credit information.
  7. Company will assess handling charges in the amount of $25.00 for any dishonored check received from the applicant.
  8. I/we hereby agree to indemnify the company for all collection fees/legal fees and all other expenses, which the company incurs should my/our account fall to collection.

* I/we authorize the company to charge my/our current purchases
and/or past due accounts to my/our credit card.

Credit Card Information
Name of Cardholder *
Card Number *
Card Type *
Expiry Date *

* I/we acknowledge that I/we have read and fully understand the terms and conditions
of this account agreement. This application is subject to approval of the Company’s
Credit Department. I/we affirm the information is true and correct.

* I AM THE APPLICANT NAMED HEREIN OR AN AUTHORIZED REPRESENTATIVE
OF THE CORPORATION NAMED HEREIN.
   

Your Name *
Your Title *
Application Date
Feb 8, 2012