Rogers Rent-All Ltd

To apply for credit with Rogers Rent-All™ please fill out the application, print, sign and fax to (403) 277-4466.
Our financial department will review your application and you will be contacted shortly.

General Information:

Business Name:

Mail Address:

City:

Province:

* Postal Code: *

Phone:

* Cell:

Fax:

E-mail: *

Nature of Business:

Years in Business:

* Credit Requested: *

A/P Contact:

Purchase Order Required:

Yes No*

Corporate Information:

Your Name:

Position:

Head Office Street Address:

City:

Province:

Postal Code:

DAMAGE WAIVER: Covers up to $500.00 of Accidental Damage per Contract.
COST: 6% of Total Rental Charges. Does not include: Damage due to abuse, freezing, improper maintenance, transportation while on rent, loss or theft.
Damage Waiver Requested: Yes No*

Principals:

Name:

Home Address:

City:

* Phone: *

Driver's Licence:

Name:

Home Address:

City:

Phone:

Driver's Licence:

Bank Information:

Bank:

Contact Name:

Bank Address:

City:

* Phone Number:

Trade References:

(Companies presently extending credit)

Company:

Phone:

Fax:

Company:

Phone:

Fax:

Company:

Phone:

Fax:

Terms:

Net 30 days

Date:

* Indicates Required Fields

Terms and Conditions: We understand that purchases shown on contracts and monthly statements must be paid 30 days following the date of billing. It is agreed and understood that accounts overdue to the extent of thirty days or more are subject to an interest charge of 2% per month and this charge shall be debited directly to the account and become an actual part of the total indebtedness. The undersigned warrants and certifies that the above information is correct. You hereby authorize Rogers Rent-All Ltd. to hold, use, exchange and disclose your information as required in order to administer your application for present and future considerations. The undersigned has authority to bind the applicant:

Calgary owned and operated for over 35 years