Vemco
A Division of CDP Trinidad Limited
Customer Information Form
Trade/Registered Name
Contact Name/ Position:
Business Address:
Street Address Apartment/Unit #
City
Telephone& Fax Email :
Bankers: Account Manager:
Address:
Payment Terms
requested: Credit Limit Requested:
Trade References
Trade Reference 1 Trade Reference 2
Name: Name:
Contact Person: Contact Person:
Contact Number: Contact Number:
INDIVIDUAL PERSONAL GUARANTEE
I, (we) ____________________________ for and in consideration of your extending credit at my request
to (Name of Company) _______________________________ (the Company), personally guarantee
prompt payment of any obligation of the company to Vemco, whether now existing or hereinafter incurred,
and I further agree to bind myself to pay on demand any sum which is due by the Company to Vemco
whenever the Company fails to pay same. It is understood that this guarantee shall be an absolute,
continuing and irrevocable guarantee for such indebtedness of the Company.
I expressly waive presentment, demand, protest, notice of protest, dishonor, diligence, notice of default of
non-payment, notice of this acceptance of this guarantee, notice of the extending of any guarantied
indebtedness already of hereafter contracted for by the Company, notice of any modification or renewal of
any credit agreement advancing the indebtedness hereby guarantee, notice of any renewal or extension
of such indebtedness, and I expressly consent to any modification or renewal of any credit agreement
evidencing the indebtedness hereby guarantied and to all renewals or extension of such indebtedness. I
further waive any right to require Vemco to proceed against, or make any effort at collection of the
guarantied indebtedness from the Company or any other party liable for such indebtedness.
If the guarantied indebtedness is not paid by me when due, and this guarantee is placed in the of an
attorney for collection, or suit is brought hereon, or it is enforced through any judicial proceeding
whatsoever, I shall pay all reasonable attorney’s fees and court costs incurred by Vemco. In the event
more than one party executes this Guarantee as a guarantor, then each guarantor agrees to be jointly
and severally liable for the guarantied indebtedness, and, in all instances herein, he singular shall be
construed to include the plural.
Guarantor agrees to notify Vemco by certified mail, return receipt requested immediately if there is any
change of ownership of term of business, but in any event not later than five days after same become
effective. Failure of the Guarantor to so notify Vemco and deliver said notice, this will result in said
guarantor remaining liable to Vemco for all credit purchases of the new business, corporation or new form
of business entity. All notices to Vemco should be directed to the Finance department.
We hereby give authorization to VEMCO A Division of CDP Trinidad Limited and their bankers to request
credit reports from the afore-mentioned bank on our behalf AND agree to the terms and conditions of the
individual personal guarantee.
Authorised Signatories on Account:
Name: ______________ Position:________________ Signature:_________________
Name: ______________ Position:________________ Signature:_________________
channel
Profile Customer Profile
o KEY
RETAIL-MT o CLUB STORE ACCOUNT/CHAIN
o LARGE o LARGE
PHARMACY/CHAIN SUPERMARKET
o MINI MART o MOM AND POP o GAS STATION
o VARIETY /
RETAIL-DT HARDWARE o PHARMACY o FOOD VENDOR
o VEGGIE / MEAT o LIQUOR STORE
o GYM MART o VEMCO OFFICE ACCOUNT
o MASS o CONVENIENCE
MERCHANDISER STORE
WHOLESALE o WHOLESALER O LOCAL AGENTS
o FINE DINING o CASUAL DINING o QUICK SERVICE
o HOTEL o CATERER o BAKERY
FOOD SERVICE o BAKERY SM o HEALTH CARE o CAFETERIA (SCHOOL)
o CAFETERIA
(WORK/PUBLIC) o CASINO o SHIP CHANDLER
o INDUSTRIAL o INSTITUTION o BAR / CLUB
PET CARE o PET STORE o AGRI STORE o VETERINARY
o BREEDER o PURINA EXPRESS
o EMBASSY/DIPLOM
WINE & o PRIVATE CLIENT DUTY FREE
AT o
SPIRITS
o EVENTS/ENTERTAINM
ENT
o PRIVATE LABEL
EXPORT o OWNED BRANDS BRANDS o 3rd PARTY MANAGED BRANDS
Profile
Service Day SALES TERRITORY
Business Profile Name
o Chain o Mon o Thu o CENTRAL o SOUTH
o Independent o Tue o Fri o EAST o WEST
Independent o Wed o NORTH o TOBAGO
Select below:
For Official Use Only:
Customer Code:
Sales Person:
New Customer Buying Group
Terms: Credit Limit:
Change of Address
Approved By: Date:
Change of Name
Date:
Apply for Credit
Other
