Credit Application

CUSTOMER ACCOUNT SERVICES

Apply for a 4R Waterworks credit account. Complete the application below and submit it to our credit department for review.

Secure application
Save and continue
Review before submission

1

COMPANY

2

CREDIT

3

REFERENCES

4

TERMS

5

GUARANTEE

6

REVIEW

STEP 1 OF 6

Business Details

Applicant information

Legal Business Name *

Trade Name / DBA

Phone *

Email *

Website

Billing Address *

City *

Province *

Postal Code *

Shipping Address

Business Type *

Year Started

Incorporated In

Business Identification Number (BIN)

Dun & Bradstreet Number

Account & Credit Request

Purchasing and accounts-payable information

Accounts Payable Contact *

Accounts Payable Email *

A/P Phone

Estimated Monthly Purchases

Credit Limit Requested

Terms RequestedCODNet Terms

Do you require a purchase order number before we accept an order?YesNo

Principal / Owner Information

Authorized business representative

Capacity

Name *

Home Address

City

Province

Postal Code

Home Phone

Mobile

Bank & Trade References

Credit reference information

Bank Reference

Bank Name

Contact Name

Phone

Address

Trade Reference 1

Supplier

Contact

Phone

Email / Address

Trade Reference 2

Supplier

Contact

Phone

Email / Address

Trade Reference 3

Supplier

Contact

Phone

Email / Address

Terms & Authorization

Acceptance required to submit

4R Waterworks Credit Terms & Conditions

The Credit Application Terms & Conditions are available on the 4R Waterworks website and form part of this Credit Application. Please review them before submitting your application.

VIEW CREDIT TERMS & CONDITIONS ↗

Personal Guarantee

Where required

Personal Guarantee – execution required where applicable

If the Applicant is a corporation or similar entity, an owner or director must complete the Personal Guarantee and the signature must be witnessed.

Guarantor Name *Title *Date *

Guarantor Signature

Draw your signature, or switch to TYPE and write your full name. The signed image is sent with the application.

Witness Name *Witness Email *Date *

Witness Signature

Draw your signature, or switch to TYPE and write your full name. The signed image is sent with the application.

By submitting this Credit Application, the Applicant confirms acceptance of the 4R Waterworks Credit Application Terms & Conditions.

Your application will be submitted securely to the 4R Waterworks credit department for review.

Complete Your Application

Provide your company, credit, banking and trade-reference information.

Review the Terms

Review the 4R Waterworks Credit Application Terms & Conditions before submission.

Submit for Review

Once submitted, your application will be forwarded to the 4R Waterworks credit department for review.

CUSTOMER ACCOUNT SERVICES