Open An Account APL Aerial Platforms Credit Account Application FormCompany Type (please tick one box)* Limited Non Limited Other (please specify)Specify Company Type:Company Name* Trading StyleNature of BusinessAccounts & BuyingAccounts DepartmentAccounts Contact Name Accounts Telephone NumberAccounts Mobile NumberAccounts Fax NumberAccounts Email Buying DepartmentBuying Contact Name Buying Telephone NumberBuying Mobile NumberBuying Fax NumberBuying Email Health & Safety DepartmentHealth & Safety Contact Name Health & Safety Telephone Number Health & Safety Email We will email a report to your Buying contact on a regular basis detailing "What's Out Where".This allows you to manage any platforms that you have on hire.Electronic Invoicing & StatementsWe submit all Sales Invoices via email to reduce any negative impact on the environment.Email Contact for electronic invoicing & statementsPlease confirm Email Contact for Receipt of Electronic Invoicing and Statements. Address DetailsInvoicing Address Street Address Address Line 2 City State Zip/ Postal Code Trading Address is the same as Invoicing AddressTrading Office Address Street Address Address Line 2 City State Zip/ Postal Code Company Registration NumberYour Bank DetailsName of BankAccount NameSort CodeAccount NumberHow did you hear about us?Please select below APL Sales Person Internet Search Saw Our Equipment On Site Information From A Colleague Trade Journal Used In Previous Job Recommendation Other (please specify)Please specify how you heard about usHired In Plant InsuranceYour Company (HIP) Insurance DetailsName of (HIP) InsurerPolicy ReferenceCertificate expiry datePlease provide an up-to-date copy of your "Hired In Plant Insurance" CertificateInsurance of the equipment is the customer's responsibility. It is the condition of hiring that each customer has "Hired In Plant Insurance". In the absence of your own insurance please be advised APL will charge a default 20% of the hire charge under our Indemnity Scheme APL Protect+, which covers the theft and loss of Powered Access hired from us (exclusions apply). Alternatively this may be reduced to 10% of the hire charge by accepting APL Protect only (exclusions apply), Please tick below:APL Protect & Protect+*Find out more about APL Protect and APL Protect+ and Read Terms & Conditions here APL Protect: Offers cover from accidental damage, but not theft of machines APL Protect+: Offers cover from accidental damage, theft, malicious damage & destruction I do not require APL Protect or APL Protect+Upload "Hired In Plant Insurance" CertificateYou can also email this to us at firstname.lastname@example.org, or post it to our address at the bottom of this page.Failure to provide a valid Hired In Plant Insurance Certificate will result in no account being opened.Terms & Conditions Of HireTHE DATA PROTECTION ACT 1998 - IMPORTANT INFORMATION: BEFORE signing this application form, it is important that you read the notes below which set out how we collect and use information about you for the purpose of providing credit facilities. We will make searches about you at a credit reference agency who will supply us with credit information, as well as information from the Electoral Register. The agencies will record details of the search whether or not this application proceeds. We may use credit scoring methods to assess this application and to verify your identity. This information may also be used for debt tracing and the prevention of money laundering as well as the management of your account. By signing this application, you agree that we can use your information in this way.I/WE accept the Terms and Conditions of the Construction Plant Hire Association Model Terms for the Hiring of Plant (July 2011) and agree to be bound by these. I/WE understand that APL Protect & APL Protect+ premiums will be levied should I/WE elect not to provide alternative arrangements. I/WE understand and accept as the basis of trading the terms and conditions of 30 days Nett and that you shall reserve the right, without prejudice to any other remedies to recover the goods when any sum due remains unpaid. In the event that we do not adhere to your terms of trade, details of our payment performance may be passed to be licensed credit reference agency.I/WE declare that the information provided to retain to this application is correct and that I/WE have had and agree your conditions of trading. I/WE authorise you to make enquires in relation to this credit account application at your discretion. I/WE understand that you may refuse to open a credit account without giving reason.I/WE accept the CPA Terms & Conditions as outlined in this document.Tick box to confirm* I accept the Terms & Conditions of HireName of Signee*By entering your name here you are electronically signing this document.PositionYour Position within your businessRelated ServicesAPL also provide a range of Access Related products and services.Please select any of the services that are of interest to you and a member of staff will be in contact. Scaffolding Hire IPAF Training Pasma Training Machine Spares PPE Sales Harness Hire Harness Sales Machine Sales Machine Service General Plant / ToolsNameThis field is for validation purposes and should be left unchanged.