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					                                                                                                PO Box 9610
                                                                                                Vancouver, BC Canada V6B 4G3
Commercial Credit Application                                                                   Tel: (604) 668-5386 or 1-800-331-7353
PLEASE COMPLETE IN FULL TO EXPEDITE PROCESSING                                                  Fax :(604) 668-5656

                                                                          COMPANY INFORMATION
                                                                                     Sole Proprietorship        Year business established
                                                                                     Partnership                Year present ownership started
                                                                                     Limited Company            Business affiliated with / Controlled by

 LEGAL BUSINESS NAME                                                                 Other
                                                                                 NATURE OF BUSINESS
 NAME OF PRINCIPAL (IF SOLE PROPRIETORSHIP)
                                                                                 EMAIL ADDRESS:

 BILLING ADDRESS                                                                 Business Phone Number          Business Fax Number
                                                                                 (     )                        (     )
 CITY                               PROVINCE                POSTAL CODE          Cellular Phone number          Fleet/Operations Manager Name
                                                                                 (     )
Personal Guarantee Signed? Financial Statements for 20___ are available.         Accounts Payable Contact       Accounts Payable Fax number REQUIRED for US Purchases
     YES     NO            Financial Statements attached:    YES       NO                                       (    )
                                      FULL NAMES AND ADDRESSES OF PRINCIPALS, PARTNERS OR COMPANY OFFICERS
 Name                                                                                               Position/Occupation          Date of Birth         Social Insurance Number
                                                                                                                                MO   DAY     YR
 Address
                                                                                                        Home Phone                Spouse’s Name           OWN HOME
                                                                                                                                                          RENT HOME
 Name                                                                                               Position/Occupation          Date of Birth         Social Insurance Number
                                                                                                                                MO   DAY     YR
 Address
                                                                                                        Home Phone                Spouse’s Name            OWN HOME
                                                                                                                                                           RENT HOME
        ASSETS                  MARKET VALUE                MORTGAGE                                        MORTGAGE HOLDER NAME & ADDRESS
     Land & Buildings

                                                                           CREDIT INFORMATION
                    NAME                                               ADDRESS / LOCATION                                   ACCOUNT NUMBER              TELEPHONE NUMBER
 Current Fuel Supplier

 Main Bank

 Other Trade References:


 Other Chevron Account Number:

                                                                       PURCHASING INFORMATION
   ESTIMATED MONTHLY DIESEL PURCHASES               ESTIMATED MONTHLY GAS PURCHASES WITHIN CANADA                      ESTIMATED MONTHLY FUEL PURCHASES WITHIN
                WITHIN CANADA                                                                                                 THE UNITED STATES See note below
                                          Litres                                                         Litres                                                        Litres
Or                                       Dollars Or                                                    Dollars Or                                                 US Gallons
 NOTE REGARDING US PURCHASES:
     INVOICE FREQUENCY FOR US PURCHASES: Weekly invoice payment due 7 days from date of invoice.
     PAYMENT BY PREAUTHORISED DEBIT ONLY. Completed Preauthorised Debit form must be submitted.
     OREGON STATE PURCHASES: In order to purchase fuel, other than gasoline, in the state of Oregon a special license is required.
     Proof of this license must be faxed or mailed to Chevron Canada Ltd for access to Oregon facilities. Requests for application forms and information can be directed to
     the Oregon Department of Transportation, Fuel Tax Group, 550 Capitol St. N.E., Salem, OR 97301-2530. Phone (503) 378-8150, FAX (503) 378-3060
 DELIVERY LOCATION / ADDRESS

                                                                                 AGREEMENT
 By applying for a Chevron Commercial Account and for the purpose of granting credit and providing credit services, I consent and give authority to Chevron Canada
 Limited to make the usual credit inquiries any time in connection with the credit applied for and to disclose personal information to other credit grantors, reporting and
 collection agencies, affiliated companies, financial institutions, card embossers and electronic bill presentment service providers. I also agree, unless I request otherwise,
 that Chevron may use my information for the purpose of informing me about products or services available from Chevron. The undersigned agrees to abide by the allowed
 credit terms, which may be changed from time to time, and understands that a late payment charge will apply to overdue accounts. The undersigned agrees that it will
 periodically provide to Chevron that financial information or security deemed necessary by Chevron to support any credit extension. If during the life of any agreement
 with Chevron the undersigned's financial capacity becomes impaired or unsatisfactory to Chevron, in the sole judgment of Chevron, advance cash payment or security
 satisfactory to Chevron will be given by the undersigned on demand by Chevron and shipments/deliveries may be withheld until such payment or security is received.
 The undersigned acknowledges that the account will be used primarily for business purposes.
                                                                                           FOR:
 SIGNATURE OF CUSTOMER                                                                     PRINT COMPANY/
 AUTHORISED SIGNING                                                                        PARTNERSHIP NAME
 OFFICER
 PRINT NAME & TITLE                                                                                                  DATE                                             20




Please complete both pages and mail to: Chevron Canada Limited P.O. Box 9610, Vancouver, B.C. Canada V6B 4G3
Page 1 of 2                             O:\VN1050-Finance\CAS\Masters\Applications\CD1 Commercial Application1107.doc                                            CD1 (Nov 07)
Commercial Credit Application                                                                                                                             continued
                                                          TAX EXEMPTION INFORMATION (IF APPLICABLE)
 If M ARKED DIESEL is to be authorised in British Columbia, a “COLOURED FUEL ACCOUNT CERTIFICATION” form must be submitted to Chevron prior to authorising Marked
 fuel purchases. Forms can be found at www.rev.gov.bc.ca/ctb/forms/0438FILL.pdf or by calling Taxpayer Services at 1-877-388-4440.
 If M ARKED DIESEL is to be authorised in Alberta, Declaration number & effective date must be provided.
      DECLARATION NUMBER                                                            EFFECTIVE DATE

     ALBERTA FARM FUEL DISTRIBUTION ALLOWANCE CERTIFICATE OF ELIGIBILITY NUMBER
 If you are exempt from any federal or provincial taxes please indicate the exemption type, applicable exemption numbers and enclose copies of the relevant tax
 certificates.
      EXEMPTION TYPE                                                            EXEMPTION NUMBER

 OREGON USE FUEL TAX: Proof of this license must be submitted to Chevron Canada Limited prior to access to Oregon facilities.


                                                                           CARD INFORMATION

ACCOUNT NAME
                                                                  INDIVIDUAL CARD CUSTOMISATION
CARD FEATURES
   Each driver keeps their own card                                        All product information, site authorisations, & card options are linked to this one card
   Each card has a Personal Identification Number                          A Vehicle number can be embossed on the card
   (Pre-assigned PIN or Custom PIN if requested)                           (This number will also print next to the card number on your Cardlock invoice)

 NUMBER                    PRODUCT INFORMATION                                   SITE AUTHORISATIONS                    CARD OPTIONS              VEHICLE #
OF CARDS                                                                                                               ON-SITE MANUAL          Maximum 4 Digits
                                                                                                                           ENTRY            Embossed on cards. Prints
                                                                                                                                                  on invoice

                   All products (excludes marked)                             All B.C.                                Miscellaneous         _____|_____|_____|_____
                   Clear Diesel Only                                                                                  Number                _____|_____|_____|_____
                                                                              All Alberta & Saskatchewan                 Yes      No        _____|_____|_____|_____
                   Gas only (excludes marked)                                                                                               _____|_____|_____|_____
                   Other ___________________                                  United States                           Odometer Number       _____|_____|_____|_____
                                                                              Oregon Use Fuel License required          Yes      No         _____|_____|_____|_____
                   All products including Marked                                                                                            _____|_____|_____|_____
                   All customers must complete the TAX                        United States excluding Oregon          Choose your own       _____|_____|_____|_____
                   EXEMPTION INFORMATION section on page 1                                                            PIN number?**         _____|_____|_____|_____
                                                                                                                      (See note below)      _____|_____|_____|_____
                                                                                                                         Yes      No


                   All products (excludes marked)                             All B.C.                                Miscellaneous         _____|_____|_____|_____
                   Clear Diesel Only                                                                                  Number                _____|_____|_____|_____
                                                                              All Alberta & Saskatchewan                 Yes      No        _____|_____|_____|_____
                   Gas only (excludes marked)                                                                                               _____|_____|_____|_____
                   Other ___________________                                  United States                           Odometer Number       _____|_____|_____|_____
                                                                              Oregon Use Fuel License required          Yes      No         _____|_____|_____|_____
                   All products including Marked                                                                                            _____|_____|_____|_____
                   All customers must complete the TAX                        United States excluding Oregon          Choose your own       _____|_____|_____|_____
                   EXEMPTION INFORMATION section on page 1                                                            PIN number?**         _____|_____|_____|_____
                                                                                                                      (See note below)      _____|_____|_____|_____
                                                                                                                         Yes       No

   **CUSTOM PIN : A COMMERCIAL ACCOUNTS SERVICES REPRESENTATIVE WILL CONTACT YOU REGARDING THE CUSTOM PIN ONCE THE ACCOUNT HAS BEEN APPROVED**



                                                                  ADDITIONAL CARD CUSTOMISATION

Please contact our Commercial Account Services at 604-668-5386 or 1-800-331-7353 for additional card & account customisation
     Payment via Pre-Authorised Debit                                              Summary Reports of transactions
     Purchase restrictions on card                                                   • Purchases by Vehicle Number then Province or State
     Restricted number of transactions per day per card                              • Purchases by Card Number then Province or State
     Volume limit per card                                                           • Purchases by Miscellaneous number then Province or State
     Volume limit per account                                                        • Volume & Tax Summary by State or Province
     Internet access to view transaction data on the Web in real time




Please complete both pages and mail to: Chevron Canada Limited P.O. Box 9610, Vancouver, B.C. Canada V6B 4G3
Page 2 of 2                             O:\VN1050-Finance\CAS\Masters\Applications\CD1 Commercial Application1107.doc                                     CD1 (Nov 07)

				
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