Account Application Form | Purple Hire Solutions

Please complete your details below if you would like to open an account with Purple Hire Solutions.

1. GENERAL INFORMATION

Name account is to be held in:

Address accounts to be sent to:

Phone

Fax

Account contact

Account phone number

2. BANK DETAILS

Bank Name

Account Number

Sort Code

3. ACCOUNTS

Contact

Telephone number

Fax number

Accounts email address

Invoice transmition

4. TYPE OF BUSINESS

Type of business:

Partnership

Sole Trader

Limited

Registration no. if limited:

Name of Trader/Partners

How many years trading:

Are order numbers required:

5. TRADE REFERENCES

First trade reference:

Name of company

Contact name

Telephone number

Second trade reference:

Name of company

Contact name

Telephone number

6. INSURANCE

In accordance with our terms and conditions we levy a damage / loss waiver on all hire contracts at the rate of 15% of the hire charges. If you have insurance cover for 'Hired in plant' please arrange to send us proof of cover. This can be either a copy of your schedule or a 'To whom it may concern' letter from your insurers stating the effective dates and level of cover.

HIP cover

YESNO

Policy number

Start date

Insurer

Level of cover

Expiry date

Proof of cover

Upload a PDF file

7. DECLARATION

Under the General Data Protection Regulations we are required to obtain permission to store and process personal data. The information we store and use is to enable us to trade with you. Purple Hire Services Ltd does not and will not sell, rent or trade your personal information. We will only keep the minimum amount of information required. Your data will be treated confidentially throughout your business relationship with us and will be retained for 7 years following the conclusion of our business relationship.

Name

todays date

Position

Signature

YESNO

Please select yes if you all the information you have given is correct. This is used as a digital signture of the person named.