INSCRIPTION FORM
Company name
:
Address
:
(hereby called « THE CLIENT »)
Postal code :
Telephone :
Fax :
Email :
Number of Employees :
Number of years in business :
GST
PST :
:
Spokesperson for company :
Authorized sales person(s) :
Type of business
:
Name of your Bank
:
Address
:
Telephone number
:
Account number:
Name and address of administrators :
Name :
Birth date :
Address :
Telephone :
Name :
Birth date :
Address :
Telephone :
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MULTITECH ENVIRONNEMENT, C.P. 187, Rouyn-Noranda (Quebec) J9X 5C3 Tel. : 819-762-6282 Fax : 819-762-5176
2
Names of two suppliers and references :
Name :
Telephone :
Fax :
Name :
Telephone :
Fax :
CONDITIONS
THE CLIENT undertakes to pay within thirty (30) days following the date of each invoice. Any outstanding
balance will bear an interest of 18 % per annum, composed mensually.
If MULTITECH ENVIRONNEMENT has to entrust a law firm to collect any unpaid balance, THE CLIENT agrees
to pay an additional 20 % of the total amounts, as liquid damages, as indemnity for the legal fees and perception
expenses as well as for troubles.
If the client is a company, all signatories of this document hereby guarantee jointly and severally, without division or
discussion, with the said company, that they will carry out all and every obligation towards MULTITECH
ENVIRONNEMENT (3766063 CANADA INC.).
Fees of $10.00 will be charged for any cheque returned by the bank, whatever the reason.
This agreement shall bind THE CLIENT for all transactions with MULTITECH ENVIRONNEMENT in the future.
These general conditions apply to each invoice as if they were written all of these.
The parties agree to make an election of domicile in the District of Rouyn-Noranda, Province of Quebec.
THE CLIENT authorizes MULTITECH ENVIRONNEMENT (3766063 CANADA INC.) to verify with his bank,
suppliers and sources of information other than those mentioned on the inscription form, in order to give or maintain
credit margin to THE CLIENT.
THE SIGNATORY hereby agrees to meet the obligations contracted by THE CLIENT.
THE CLIENT, through his representative(s), duly authorized, hereby agrees to these previously mentioned
conditions.
SIGNED AT
THIS
20
Name of company :
Signature
: X
Signature of duly authorized representative(s)
The undersigned signatory(ies) is/are jointly responsible for the
obligations controlled for/by the client company:
Signature
: X
Signature of duly authorized representative(s)
MULTITECH ENVIRONNEMENT, C.P. 187, Rouyn-Noranda (Quebec) J9X 5C3 Tel. : 819-762-6282 Fax : 819-762-5176