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Client Prepaid Form: Customer Information

This document is a client prepaid form for Bureau Veritas Commodities Canada Ltd. It collects customer contact and company information. It specifies requirements for invoices and methods of prepayment including purchase order, electronic funds transfer, check, or credit card. By signing, the customer agrees to provide accurate information, be responsible for debts, and allow credit card information to be kept on file for future payments.

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Tony Gary
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190 views2 pages

Client Prepaid Form: Customer Information

This document is a client prepaid form for Bureau Veritas Commodities Canada Ltd. It collects customer contact and company information. It specifies requirements for invoices and methods of prepayment including purchase order, electronic funds transfer, check, or credit card. By signing, the customer agrees to provide accurate information, be responsible for debts, and allow credit card information to be kept on file for future payments.

Uploaded by

Tony Gary
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Client Prepaid Form

CUSTOMER INFORMATION
Legal Name Contact Name
Billing Address City
Province/State Zip Code
Country Contact Email
Contact Tel. Registration #
Legal Structure Ƒ Privately-owned Ƒ Publicly-owned Registration date
Incorporation Date Province/State of Registration

INVOICING & PREPAYMENT REQUIREMENTS


Required Purchase Order Ƒ Yes Ƒ No Invoice via email Ƒ Yes Ƒ No
PO# Invoice via hard copy Ƒ Yes Ƒ No
BV Proforma/Quote/Job# Invoice via WebAccess Ƒ Yes Ƒ No

INSTRUCTIONS PAYMENT
Payment via EFT (CAD Account) Payment via EFT (USD Account)

Company Name: Bureau Veritas Commodities Canada Ltd.


Company Name: Bureau Veritas Commodities Canada Ltd. Bank Name: HSBC
Bank Name: HSBC Bank Address: 885 West Georgia St.
Bank Address: 885 West Georgia St. Vancouver, BC V6C 3G1 – Canada
Vancouver, BC V6C 3G1 – Canada Account #: 428755-070
Account #: 428755-001 Bank Transit #: 10270-016
Bank Transit #: 10270-016 Swift Code #: HKBCCATT
Swift Code #: HKBCCATT Correspondent Bank: Citi Bank
Swift Code # for USD: CITIUS33
Payment via Check
Bureau Veritas Commodities Canada Ltd.
(Result will not be released until check has cleared the
9050 Shaughnessy St. - Vancouver, BC V6P 6E5 – Canada
bank)
Payment via Credit Card
(Result will not be released until payment has cleared the Credit Card Information table to be completed below
processing center)

By signing below, you affirm that you are an authorized agent for your company, and authorized user of the card listed below, and are requesting Bureau
Veritas Commodities Canada Ltd. to charge the credit card for payment in advance of services being rendered. You also authorize the credit card
information to be kept on file to be processed for future service / invoices. All legal matters will be settled in court in British Columbia, Canada for non
payment on our services.

CREDIT CARD INFORMATION


Name on Card Ƒ AMEX (CAD) Ƒ VISA Ƒ MASTERCARD
Card Number Security Code
Payment Amount Expiration Date
Billing Address Type of Card

Signature Date

By signing this application form, I hereby also acknowledged and agreed that the above information is true and correct, and that the above named
1

company will be responsible for all debts incurred under that company’s name.

Name: Title:

Signature: Date:

F-FIN100.1-CA Client Prepaid Form (E879) 05182017 P1 of 2


Return to your local office, Bureau Veritas.
Send by email to acct.receivable@ca.bureauveritas.com

Send by mail to:


Bureau Veritas Commodities Canada Ltd.
9050 Shaughnessy St.
Vancouver, BC V6P 6E5
Canada
Tel. (1) 604 253 3158

F-FIN100.1-CA Client Prepaid Form (E879) 05182017 P2 of 2

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