CONTRACT FOR CARRIAGE AND APPLICATION FOR CREDIT FACILITIES between the Customer and DSV Road (Pty) Ltd t/a DSV Distribution PO Box 63, The Reeds, 0061 | 1 Mann Road, Louwlardia, Centurion, 0157 Registration No.: 2000/016342/07 | VAT No.: 488 018 9685 | Tel.: +27 12 673 2000 To be completed in black pen by an authorised signatory. Please return the original to DSV Road (Pty) Ltd t/a DSV Distribution. PLEASE READ & INITIAL CONTRACT FOR CARRIAGE OVERLEAF. COMPANY DETAILS 1. Name of Customer (full registered company name): . 2. Trading As: . 3. Nature of Business: . Industry: . 4. Names of Holding / Parent Companies: . 5. Names of Associated / Subsidiary Companies: . 6. Type of Company (please tick one): Public Company Private Company Close Corporation Partnership Sole Proprietor Trust / Trustee 7. Company Registration No.: . Date of Commencement of Business: D D M M Y Y Y Y 8. VAT No.: . Customs Code (Importers and Exporters): . 9. Street Address: . Town: . Postal Code: . Postal Address: . Postal Code: . 10. Tel. No.: . E-mail Address: . 11. Please list the details of the Directors / Members / Proprietor / Partners / Manager (Delete whichever are not applicable). For additional please attach list Name: . Designation: . ID No.: . Name: . Designation: . ID No.: . Name: . Designation: . ID No.: . 12. Trade References Company name:. Contact Person:. Tel. No.:. Company name:. Contact Person:. Tel. No.:. Company name:. Contact Person:. Tel. No.:. 13. Names of companies within DSV with whom you have an account or with whom you have had dealings: Name: . Account No.:. Name: . Account No.:. 14. Current Logistics Service Provider:. ACCOUNT MANAGEMENT INFORMATION National Credit Act & Consumer Protection Act Details 15. Revenue for the year greater than R1 million: Yes No Asset value at year end greater than R1 million: Yes No 16. Above information stated from latest Annual Financial Statements dated: D D M M Y Y Y Y We hereby consent to the company, DSV Road (Pty) Ltd t/a DSV Distribution to make enquiries in its sole discretion as it may deem necessary, relating to the Customer’s credit record and trade references with any credit agency or any third party. The Company may likewise provide reference agencies with updates regarding the Customer’s accounts and including, if the occasion arises, any failure by the Customer to meet any agreed terms and conditions of payment. BANK & PAYMENT DETAILS 17. Bank Name: . Branch: . Account No.: . Maximum Monthly Credit Required: R. 18. Payment Contact: . Tel. No.: . E-mail: . Finance Management Contact: . Tel. No.: . E-mail: . PLEASE ATTACH PROOF OF BANKING DETAILS 19. Invoice VAT Option.: 20. Statement E-mail: Detailed Summary Frequency: Monthly Weekly Daily I/We warrant that the information herein provided is true and correct and that I/we have the authority to contract with DSV Road (Pty) Ltd t/a DSV Distribution on behalf of the Customer on these terms and conditions, and that the Customer is bound by the Contract for Carriage which is printed on the reverse hereof, and initiated by me/us to denote acceptance thereof. The Customer agrees to abide by the credit terms of DSV Road (Pty) Ltd t/a DSV Distribution, including making payment to DSV Road (Pty) Ltd t/a DSV Distribution within 30 days of statement, failing which interest may be charged on overdue amounts at the current legal mora interest rate. I/We agree that DSV Road (Pty) Ltd t/a DSV Distribution may conduct a credit reference/credit record search or investigation in respect of the Customer from any bureau or credit information centre for which this is the Customer’s formal consent. Name:. Signature: . Position:. Date: D D M M Y Y Y Y INTERNAL USE ONLY Sales Executive: . Code: Date: D D M M Y Y Y Y Salesforce No.: Credit Controller: . Approved Credit Limit: . Payment Terms Approved: Y N Approved by: . Account No.: Date: D D M M Y Y Y Y Version August 2017 NATIONAL CONTACT CENTRE: 0861 80 30 80 | www.za.dsv.com
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