Builder Application Form

Business Contact Information:

Name *

Phone *

Email: *

Business Name *

ABN Number *

Builders Licence No.

Please Upload a copy of your Builders Licence

Choose File

Address - Please include State and Postcode *

Postal Address - Please include State and Postcode *

Date your business started *

Company Structure *

Please Specify Company Structure

Accounts Contact Person *

Accounts Phone Number *

What email address should we send invoices to? *

What email address should we send quotes to? *

Builders/Construction Companies: All doors must be paid for in full prior to installation. A 50% deposit is required upon acceptance of the quotation with the final payment to be made prior to the day of installation. There will be a 5% discount on the total price when the full and final payment is received prior to the door, parts or motor being installed.

Credit References & Bank Information

Referee 1

Please complete the details below for your credit reference

Business Name

Contact Number

Contact Name

Years Traded With:

Referee 2

Please complete the details below for your credit reference

Business Name

Contact Number

Contact Name

Years Traded With:

Referee 3

Please complete the details below for your credit reference

Business Name

Contact Number

Contact Name

Years Traded With:

Please tick any special requirements that we need to fulfill:

Risk Assessment Form to be completed by technicians onsite

Asbestos Register Requirements

Management Portals Used – please provide details if we need to access

Other

Other - Please Specify

Special Conditions

Risk Assessment Form to be completed by technicians onsite

Asbestos Register Requirements

Management Portals Used – please provide details if we need to access:

Any Additional Special Conditions:

Terms & Conditions:

i. Any sums due under this contract that are not paid on the due date may accrue interest.

ii. Should payment remain outstanding beyond the payment terms as above, the customer is liable for all costs including legal costs and mercantile agents fees incurred by the seller in recovering the amount outstanding.

iii. The law of all contracts arising between the seller and the customer is the law of NSW and the parties agree that all claims and disputes relating to the goods sold shall be determined in the court of competent jurisdiction nearest Sutherland.

By submitting this application you confirm acceptance of PT Doors Terms and Conditions, a link to which has been supplied on the following links:

I have read and accept the Terms and Conditions? *

I agree

I Disagree

Customer Acknowledgement:

By completing the below, I hereby confirm that I am an authorised agent/representative of the company applying for credit and agree to the terms and conditions above.

Please enter today's date:

Full Name

Position

By typing my full legal name below, I agree to all of the terms and conditions of this form.

Full Name Signature

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