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Credit App

Step 1 of 2

50%

Name

First Last

Type of Industry:(Required)

Type of Industry (2)

Sole Trader

Partnership

Limited Company

Trust

Other

Trade Name:(Required)

Delivery Address:(Required)

Postal Address:(Required)

Business Email:(Required)

Business Telephone:(Required)

Business Mobile:

Registered Office:

Company Number:

Date of Birth (if sole trader):

Previous Address Details (If less than 2 years):

Details of Partners (if Partnership) or Details of Directors (If Limited Company)

Principal:(Required)

Position:(Required)

Proprietor

Partner

Director

Manager

Other

Principal Email:(Required)

Principal Telephone:(Required)

Principal Mobile:

Second Principal (If applicable):

Second Principal Position:

Proprietor

Partner

Director

Manager

Other

Second Principal Email:

Second Principal Telephone:

Second Principal Mobile:

Contact Person for Accounts:(Required)

Accounts Email:(Required)

Accounts Telephone:(Required)

Email for invoicing:

Accounts Mobile:

Contact Person for Services:(Required)

Position in Services:

Services / Site Manager Email:(Required)

Services Telephone:

Services Mobile:(Required)

Is order number required:(Required)

Yes

No

Trade References: (excluding Credit Cards, Fuel Suppliers, Landlord, Power & Phone)

1. Name of Organisation:

1.1 Telephone:

2. Name of Organisation:

2.1 Telephone:

3. Name of Organisation:

3.1 Telephone:

I certify that the above information is true and correct and that I am authorised to make this application for credit. In accordance with the Privacy Act (1993) I authorise any person or company to give information as may be required in response to credit Inquiries. I have read and understand the Tubman Heating Limited – Terms and Conditions of Trade (overleaf,) which form part of and are intended to be read in conjunction with this Credit Application and agree to be bound by these conditions. I also understand and accept that there will be a minimum of 2 hours labour charge for normal hours & minimum of 3 hours charge for after hours jobs.

Signee Name:(Required)

First Last

Signee Email:(Required)

Date(Required)

DD slash MM slash YYYY

Signature(Required)

Signee Position:(Required)

This is a Credit Application Form under the Construction Contracts Act 2002 If you are a “Residential Occupier” please read clause 21 overleaf. COMBUSTION ENGINEERS: ALL GASES, FUEL OIL, WOOD AND COAL. BOILER SURVEYS, BOILER REPAIRS, REGISTERED GAS FITTER, ELECTRICAL SERVICES, WATER TREATMENT, STEAM & HOT WATER PIPEWORK AND SPECIALIST BOILER & PLANT COMMISSIONING

Terms & Conditions(Required)

I have read and accept the Terms & Conditions‎

Subscribe

I would like to be kept up to date with promotions/marketing/features/events.

How did you hear about us?

Search Engine (Google, Bing, etc)

Social Media

Word of Mouth (Family & Friends)

Referral (Business Recommendation)

Email

Other

Check all that apply

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Auckland

11 Canaveral Drive,
Rosedale Auckland 0632
+64 9 444 5076
auckland@tubman.co.nz

Wellington

2/199 Gracefield Road,
Lower Hutt 5010
+64 4 939 4334
wellington@tubman.co.nz

Hamilton

+64 7 838 3080
hamilton@tubman.co.nz

Hawkes Bay

+64 6 836 5649
hawkesbay@tubman.co.nz

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