Customer Application

We appreciate your interest in International Carriers (Tilbury) Inc. As per our company policy we require every new customer to complete the following questionnaire in order to establish a line of credit. This questionnaire must be filled out by an authorized officer of your organization. Partially completed applications cannot be processed.

Contact Information

Name of Controller

A/P Contact Name

Bank Information

Bank Name

Branch Number

Account Number

Bank Phone Number

Bank Contact Name

Credit Requested

References

Reference 1 Name

Reference 1 Address

Reference 1 Phone

Reference 1 Fax

Reference 1 Contact

Reference 2 Name

Reference 2 Address

Reference 2 Phone

Reference 2 Fax

Reference 2 Contact

Reference 3 Name

Reference 3 Address

Reference 3 Phone

Reference 3 Fax

Reference 3 Contact

Acknowledgements

The applicant certifies that all information submitted herein is complete and accurate and authorize ICI to:

verify banking information provided
contact trade name provided
obtain further information about your firm from time to time
check the information you have given us from time to time
authorize any person we may contact to provide us with such information.

Payment Information:

PAYMENT TERMS: NET 30 DAYS, upon credit approval.

Receive copy of invoices and backups via mail?

Email Invoices To

Payment will be made with:

Cheques Direct Deposit

Interest will be charged at a rate of 3 percent per month on account over 30 days.

The applicant agrees to:

Pay all costs incurred to collect any amount due, including all legal fees.
Submit a financial statement, if requested.
Understands and agrees to comply with ICI payment terms.

C-TPAT Highway Carriers Survey:

To all of our valued Business Partners:

In light of CBP's minimum security criteria for C-TPAT Highway Carriers and in the interest of promoting secure and efficient trade, we would like to request that as a business partner of International Carriers (Tilbury) Inc. that you complete and return the following survey to us.

Date

Name and Title

Please verify your participation in the following Industry Partnership Programs:

FAST

Approved Applied NA

C-TPAT

Approved Applied NA

PIP

Approved Applied NA

CSA

Approved Applied NA

SVIP

Approved Applied NA

Do you currently have a security policy that is enforced at your facility?

Are your employees trained to detect and report suspicious behaviour?

As highway carriers have the ultimate responsibility for all cargo loaded aboard their trailer or conveyance, we would like to stress the importance of supply chain security and encourage you to participate in the above mentioned industry partnership programs.

Thanks for your time and consideration,
International Carriers (Tilbury) Inc.