CREDIT APPLICATION FORMKREDIET AANSOEK VORM

GAUTENG BRANCH -TEL: 012 377 9000

Email: clientservice@ transpharm.co.zaEmail: orders@ transpharm.co.zaW ebsite: www.transpharm.co.za

WESTERN CAPE BRANCH -TEL: 021 929 2120Email: infowc@ transpharm.co.zaW ebsite: www.transpharm.co.za

This form must be completed in full by the applicant and returned to:• Tel: 0 12 3 7 7 9 0 9 2 ( Option 1) or• Fax : 0 8 6 4 16 15 7 1• Email: newaccounts@ transpharm.co.za

If Company/Close Corporation/Trust/Partnership: FULL NAME OF BUSINESS: REGISTRATION NUMBER:

(Pty) Ltd Ltd Close Corporation Partnership Trust (please tick the appropriate box)

Please include a copy of the official registration document and furnish full names of all directors/members/trustees/partners

1. ID:

2. ID:

3. ID:

4. ID:

NATURE OF THE BUSINESS: CONTACT PERSON: DESIGNATION: Note: If the applicant is a medical doctor and the account will not be held in his/her own name, then the attached dedicated form for medical doctors must also be completed and returned together with this application form.

TRANSPHARM PTY LTD Registration Number: 1994/006582/07

(“Transpharm”)

CREDIT APPLICATION

1. APPLICANT DETAILS:

Application for: (Tick appropriate box) 30 day account (No Minimum Order)

Cash on delivery (R1000 Minimum Order) 30 day account (R1000)

If individual / sole proprietor:

FULL NAME AND SURNAME: _

IDENTITY NUMBER:

Please attach a copy of your identity document

MARITAL STATUS:

IF MARRIED, STATE:

Antenuptual agreement (married out of community of property)

In community of property (in which case this application is to be in the name of and signed by both spouses)

Other (Please specify)

This form must be completed in full by the applicant and returned to:

Tel: 012 377 9092 (Option 1); or • Fax: 086 416 1571 • E-mail: newaccounts@transpharm.co.za

FOR OFFICE USE: INFORMATION AND/OR COMMENTS: Account No: Rep Name:

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5. TRADE REFERENCES:

Company Name Address Tel No. Fax No. Credit Limit Monthly Purchase

Date account opened

Security provided

               

               

               

6. GRANTING OF CREDIT:

6.1 Transpharm will notify you in writing within approximately 7 (seven) working days after receipt of the duly completed credit application form whether or not your application for credit has been granted and also the maximum amount of credit allowed by Transpharm (“credit limit”). The credit limit shall remain in place indefinitely, provided that Transpharm shall be entitled to unilaterally revoke or suspend the facility and/or to vary and/or reduce the credit limit, from time to time.

6.2 Transpharm may, from time to time, insure its debtor’s book. In that event, you will be required to co-operate with Transpharm’s insurer and

provide assistance with regard to the furnishing of general information that may be required by the relevant insurer or its agents.

7. ACCOUNTS

Transpharm accounts are processed in the following manner:

7.1 You will be invoiced for purchases on delivery. Transpharm will render monthly statements of account to you at your postal address provided to us. The amount invoiced (“the amount due”) must be paid in full, without any deduction or set-off, within 30 (thirty) days of the date of the statement. In this context, a “month” is considered as a 30 (thirty) day period and runs from the 25th day of the month in which the statement was rendered to you, to the 24th day of the following month. In the event that the 24th falls on a Sunday or a public holiday, the month end will fall on the next business day.

7.2 Payments can be made by cheque, deposit or electronic transfer, except in the case of cash on delivery (COD) accounts which can only be

paid by means of cash deposits or electronic funds transfer (payment by cheque will not be accepted). In the case of deposits and electronic transfers, a copy of the deposit slip or proof of payment must be faxed to the relevant person at Transpharm handling your account in order for the payment to be allocated to your account.

7.3 A remittance advice must accompany the payment.

7.4 Your Transpharm account number must be quoted as a reference and, must be printed on the front of the cheque when making payment.

7.5 Any enquiries regarding your account with Transpharm may be directed to Transpharm’s accounts department, details of which will be

communicated to you.

7.6 When making payments on overdue amounts, all payments received will firstly be allocated to interest due on those amounts.

7.7 Should payments be overdue, Transpharm shall be entitled to suspend your account and not be obliged to render any further services to you, without notice, until the overdue amount and interest thereon has been paid in full.

7.8 Purchases through our respective Gauteng branch and Western Cape branch will be invoiced independently. Separate invoices and/or

statements will be issued by these branches and your account(s) must be settled directly with the branch from which you receive the invoice and/or statement.

8. INTEREST

8.1. If payments are not made timeously in accordance with paragraph 7 above, the amount due will be regarded as overdue (“the overdue amount”), and you will be liable for interest on the overdue amount, calculated from the date on which payment of the amount was due (“due date”) until date of final payment, both days inclusive.

8.2. Interest will be charged by Transpharm on an overdue amount at a rate of 2% (two percent) per month on the overdue amount of your

statement, calculated from the due date until the date of final payment, both days inclusive.

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SUPPLY TERMS AND CONDITIONS OF TRANSPHARM (PTY) LTD Registration Number: 1994/006582/07

("Transpharm")

1. Interpretation

1.1 In these terms and conditions, unless the content clearly indicates otherwise, the following terms shall bear the meanings as set out herein, and cognate expressions shall bear cognate meanings:

1.1.1 “Client” means the person or legal entity whose particulars are as set out in clause 9 below;

1.1.2 “goods” means the goods sold by Transpharm to the Client in the ordinary course of business;

1.1.3 “month” means a 30 (thirty) day period which runs from the 25th day of the month in which the statement was rendered to the Client, to the 24th day of the following month. In the event that the 24th falls on a Sunday or a public holiday, the month end will fall on the next business day;

1.1.4 “parties” means Transpharm and the Client;

1.1.5 “Transpharm” means the supplier of goods under this agreement under the Gauteng branch and/or Western Cape branch; and

1.1.6 “overdue amount” means the amount due to Transpharm after the Client has failed to make payment thereof on the due date therefor, in terms the invoice/statement rendered by Transpharm to the Client on a monthly basis.

1.2 The headings in these conditions are for the convenience only, and are not to be taken into account for the purposes of interpretation.

2. Terms and conditions These terms and conditions, read with the terms and conditions contained in the application for credit, apply to any sale of goods by Transpharm to the Client, from time to time, and supersede any terms and conditions which may be contained in any Client document. The Client agrees that any of its terms and conditions of contract are expressly excluded. Upon signature of these terms and conditions (and application for credit), the Client acknowledges and agrees that he/she/it has read these terms and conditions and considers himself/herself/itself bound by the terms hereof.

3. Exclusion and limitation of liability

3.1 Transpharm shall not be liable for any damage whatsoever (including consequential damage) suffered by the Client (including its employees and/or representatives) and/or any other user/consumer of the goods as a result of any latent or patent defects in the goods, any loss of profit or special damages of any nature unless caused as a result of a deliberate or grossly negligent act or omission on the part of Transpharm.

3.2 The Client (including its employees and/or representatives) hereby indemnifies and holds Transpharm harmless against all actions, proceedings, costs, damages, claims and demands of any kind whatsoever and howsoever arising from any cause whatsoever (including a breach by the Client of its obligations hereunder) in respect of or in relation to the use, consumption or sale of the goods, unless caused as a result of a deliberate or grossly negligent act or omission on the part of Transpharm.

3.3 The aggregate liability of Transpharm for any claims arising in connection with the supply of the goods will be limited to the actual price paid or payable in respect of the goods concerned, save to the extent that such liability cannot be excluded or limited by law.

Important Notice Please read our terms and conditions of supply carefully. These terms and conditions contain specific provisions to limit the liability of Transpharm, constitute an assumption of risk or liability by you and be an acknowledgement of certain facts by you. These terms and conditions have been set out in bold letters.

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Applicant Initial

4. Delivery and Risk

4.1 Any time or period stated for delivery of goods is approximate. Transpharm will endeavour to deliver the goods within a reasonable time of the order or within the time stipulated, if any.

4.2 Unless otherwise agreed, goods will be delivered free of charge. The despatch of the goods by courier or mail or otherwise as requested by the Client shall be at the Client’s sole risk.

4.3 The signature of any employee or agent of the Client, which appears on Transpharm’s delivery note, waybill or invoice shall constitute prima facie proof of the delivery of the goods. The Client acknowledges that it shall not be a defence in its favour that the person issuing an order, receiving goods or an invoice is not authorised or entitled to do so.

4.4 Transpharm shall not be held liable for any damages and/or inconvenience suffered by the Client (including its employees and/or representatives) as a result of a delay in the delivery of the goods ordered.

4.5 The risk in and to the goods shall deem to have passed to the Client from the time of delivery thereof.

5. Payment Terms

5.1 Payment in respect of the goods will be made in accordance with clauses 6 and 7 of the credit application, as agreed between Transpharm and the Client, from time to time. Failing an agreement to the contrary, payment shall be on delivery, without any deduction or set-off.

5.2 When payment is overdue, Transpharm shall be entitled to suspend the Client’s credit facility and any further delivery of goods, without notice and without prejudice to any other legal remedy. In addition, Transpharm shall be entitled to charge interest at the rate of 2% (two percent) per month, on the overdue amounts from the date on which the Client failed to make payment of the amount due, until the date of final payment, both days inclusive.

5.3 If Transpharm institutes legal action against the Client arising out of a breach of these terms and conditions, the Client will be liable for all legal costs incurred on the scale as between attorney and client, including collection commission.

5.4 The Client agrees and declares that an account and certificate rendered by Transpharm and certified by the manager thereof, showing the amount of the Client’s indebtedness from time to time or at any time (including interest due and accrued), shall be prima facie proof of the contents and correctness of the matters contained in such account and certificate.

6. Warranties and Exclusions

6.1 Any recommendation or suggestions relating to the goods supplied by Transpharm, either in technical literature or in response to a specific enquiry, is given in good faith, but is for the Client to satisfy himself of the suitability of the goods for any particular purposes, and he shall be deemed to have done so.

6.2 Subject to relevant laws, Transpharm’s liability under these supply terms shall be limited to replacing any goods shown to be defective or, at Transpharm’s option, reimbursement of the price paid by the Client in relation to the goods.

6.3 Transpharm shall not be liable in terms of clause 6.2 above to replace any goods delivered or in respect of incorrect execution of orders unless it receives notice from the Client within 48 (FORTY EIGHT) hours of the time of delivery, providing details of incorrect execution of orders or defective goods, to enable the complaint to be investigated. A credit w i l l be passed upon reciept of goods provided that such goods are clean, without any markings or labels and in the original sealed packaging.

6.4 Transpharm shall not be bound by or liable in terms of any representation, warranty, guarantee or undertaking made by any employee or agent purporting to act on its behalf unless such representation, warranty, guarantee be reduced to writing and signed by an authorised representative of Transpharm.

6.5 The Client (including its employees and/or representatives) indemnifies Transpharm against and holds it harmless against any claims made by any purchaser or consumer of goods sold by Transpharm to the Client arising from or incidental to any accident or injury suffered by such purchaser or consumer in respect of the sale or supply of the goods, save to the extent that such claim arises from Transpharm’s gross negligence or deliberate default or omission.

7. Cancellation and Suspension

7.1 If any amount owed by the Client is not paid on due date, then without prejudice to any other right Transpharm may have, it may immediately suspend the credit facility available to the Client and the carrying out of any of its uncompleted obligations until the payment is made.

7.2 If the Client commits a breach of any of the terms and conditions contained herein and/or the credit terms, then without prejudice to any other right Transpharm may have to claim damages against the Client, Transpharm may cancel this agreement, suspend the credit facility or any uncompleted part of it and may also claim immediate payment of any amounts due by the Client together with interest and legal costs, whether payable or not.

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Applicant Initial