LEEDS COMMERCIAL VEHICLE HIRE - CREDIT ACCOUNT APPLICATION FORM

CREDIT ACCOUNT APPLICATION FORM

Please complete & sign all forms and email to: credit.control@lcvehiclehire.com
Business Name*
Business Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Business Tel. No.*

Area CodePhone Number
Type of Business
Date First Established

DayMonthYear
Date
Company Registration No.*
Operators Licence No.*
Directors Name

First NameLast Name
Credit Limit Request*
Names of Previous or Associated Companies
Registered Office Address if Different

Street Address

Street Address Line 2

CityCounty

Post Code
Business Tel No.

Area CodePhone Number
Contact Name

First NameLast Name
Email Address for Receipt of Statements (Sent Twice Monthly)*
example@example.com
Please supply the detail of TWO trade references
1. Company Name*
Company Phone Number*

Area CodePhone Number
How long have you been dealing with them?*
2. Company Name*
Company Phone Number*

Area CodePhone Number
How long have you been dealing with them?*
INSURANCE

We require hirers to make their own arrangements for comprehensive insurance to cover hired vehicles. Please enclose a copy of the Insurance certificate and complete the attached Form of Indemnity.
PAYMENT TERMS

Terms are subject to assessment and agreement during the application process. Statements are sent out mid-month and at month end and, details the payment due dates. We will exercise our statutory right to interest under the Late Payment of Commercial Debts (Interest) Act if your account is not paid according to agreed credit terms.
Please read our terms or business and sign here*

Clear
Name*

First NameLast Name
Position within company*
Date*

DayMonthYear
Date

FORM OF INDEMNITY OWN INSURANCE

SECTION 1 - FROM
Company Name
Company Address

Street Address

Street Address Line 2

CityCounty

Post Code
Business Tel. No

Area CodePhone Number
Company Reg. No.
Company VAT No.
FORM OF INDEMNITY OWN INSURANCE

SECTION 2 - DETAILS OF OUR INSURANCE POLICY ARE AS FOLLOWS:
Policy No.*
Expiry Date*

DayMonthYear
Date
Insurance Company Name*
Insurance Company Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Phone No.*

Area CodePhone Number
Policy Cover*
Excess*
Broker Name
Broker Address

Street Address

Street Address Line 2

CityCounty

Post Code
STATEMENT

We hereby undertake that the hired vehicle(s) will at all times during the rental period and any extension thereof be covered by the above motor insurance policy,providing fully comprehensive cover in the full replacement value against all normal risks and which is valid under the laws of the United Kingdom and any other country in which the vehicle(s) is/are to be used.In addition for those vehicles on our insurance for more than 15 days the under signed agrees to update the motor insurance database with details of the regis- tration number, dates during which the vehicle was insured and the policy number without delay. Failure to report vehicles could mean that you are guilty of an offence and liable on summary conviVtion to a fine of up to £5,000.We also undertake that any driver(s) using the vehicle(s) during that period will be approved by us and will hold a valid current licence and will be duly permitted under the said policy of insurance. We further undertake to indemnify you against all claims, liabilities, losses (including loss of use), damages and expenses which you may incur arising from any breach of the above undertakings or otherwise arising from our hire and use of the vehicle not with standing any claim which you may have against the insurance company or any third party. We also agree to notify you of any changes to our insurance company, broker or policy cover.
Name*

First NameLast Name
Position*
Signature*

Clear
Date*

DayMonthYear
Date
To (Name of Vehicle Company)*

TERMS AND CONDITIONS
© of BVRLA Ltd. Only members of the BVRLA may use this document. You must not copy any part of this agreement wthout permission from the BVRLA. Version: 1.0 June 2016

INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT
Name of Account Holder*

First NameLast Name
Originators Identification Number*
Bank/Building Society Account No.*
Reference*
Instruction to your Bank or Building Society
Please pay Leeds Commercial Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand this instruction may remain with Leeds Commercial Ltd and, if so, details will be passed electronically to my Bank/Building Society.
Name of Bank/Building Society*
Address of Bank/Building Society*

Street Address

Street Address Line 2

CityCounty

Post Code
Signature*

Clear
Date*

DayMonthYear
Date
Banks and building societies may not accept Direct Debit Instructions from some types of account
THE DIRECT DEBIT GUARANTEE
- ThisGuarantee is offered by all banks and buildingsocieties that take part in the DirectDebit Scheme The efficiency and security of the scheme is monitored and protected by your own Bank or Building Society
- If the amounts to be paid or the payment dates change Leeds Commercial Ltd will notify you 10 working days in advance of your account being debited or as otherwise agreed.
- If an error is made by Leeds Commercial Ltd or your Bank or Building society, you are guaranteed a full and immediate refund from your branch of the amount paid.
- You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.
Should be Empty:

CREDIT ACCOUNT APPLICATION FORM

Please supply the detail of TWO trade references

INSURANCE

PAYMENT TERMS

FORM OF INDEMNITY OWN INSURANCE

FORM OF INDEMNITY OWN INSURANCE

STATEMENT

TERMS AND CONDITIONS

INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT

THE DIRECT DEBIT GUARANTEE