Account Application

Company Name*:

Company Reg. No*:

VAT No*:

Invoice/Statement Address*:

Are official order numbers mandatory?NoYes

Phone No*:

Accounts Contact*:

Email*:

Buying Contact*:

Email*:

Registered Office Address*:

Names & Addresses of Proprietor/Partners if not a Ltd Co*:

Business / Trade References

Trade Reference 1 Organisation*: Address*:
Contact Name*:
Phone No*:
Email*:

Trade Reference 2 Organisation*: Address*:
Contact Name*:
Phone No*:
Email*:

Can You Supply Hire In Plant Insurance?*YesNo

I accept that the hire of the goods is subject to LOC Hire Ltd terms and conditions which can be found at www.lochire.co.uk.

I confirm that I have read and understood the terms and conditions.