Customer Account Application

Accounts Payable Contact

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Purchasing Contacts

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Trade Reference #1

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Trade Reference #2

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Trade Reference #3

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Bank Information

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Disclaimer

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The information provided to Bruin Instrument Corp. will be used solely for the purpose of processing a Credit Application to obtain credit. Bruin Instruments Corp. takes our customers' security very seriously. Therefore, we take every reasonable precaution possible to keep your information safe. However, as with any information transmitted over the internet, there is a risk that the information could be viewed by a third party. Bruin Instrument Corp. does not accept liability for information submitted through this form.

Terms & Conditions

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1. Terms of payment, NET 30 DAYS from date of invoice. Change to agreement will be subject to rejection of application.
2. Returns will not be allowed without prior arrangement and proof of purchase. Returns are subject to a 10% minimum handling and restocking charge.
3. Prices are subject to change without notice. Invoices will be invoiced at process prevailing at time of order.
4. Deductions from payments for any reason will not be allowed unless company has issued a credit memo or has been notified with proof of tax exemption.
5. I/We agree to notify you of any ownership changes in the company or address for any of us. By signing this form, you are authorizing us to collect the information you provide for purpose of establishing and maintaining a credit account. As well, we will provide your information to our affiliated credit agency, Access Credit Canada. You are also authorizing us and Access Credit to use this information to generate and obtain such credit reports or other information as they may deem necessary in connection with establishing and maintaining credit accounts, collecting unpaid debts and any other direct business or credit requirements.
6. In the event of a late payment, the undersigned agrees to pay finance charges of 1.5% per month (18% per annum) on the unpaid balance exceeding 30 days. All accounts are COD until a credit application is completed, reviewed, and approved.

I am confirming that the above information is true, and I acknowledge the credit conditions of Bruin Instruments Corporation.

I am authorizing Bruin Instruments Corporation and its financial representatives to contact the above references to obtain business information of this company including detailed bank reports if filled out for the purpose of opening this account and monitoring it for this business relationship in order to obtain a line of credit.

I hereby acknowledge that I have read and understand the forgoing and that I agree to the collection, use and disclosure of personal information as described herein.