BOIAN SURGICAL

122 Gow Street, Padstow NSW 2211

ABN: 25 077 514 464

Phone: (02) 9708-5560 Fax (02) 9708-5911

Client Details:

Registered Name:

Trading As: { } Proprietary Company{ } Partnership{ } Sole Trader

Address:

Telephone : Fax : ABN : ______

Delivery Address:

Email Address:

Directors / Partners / Proprietor:

Name and Title :

Address:

Trade References:

Name:Telephone:

Name:Telephone:

Name:Telephone:

SUPPLY OF SCHEDULED PHARMACEUTICALS

NSW Poisons Regulations require you to supply a copy of your license to "Supply by Wholesale Poisons and/or Restricted Substances for Therapeutic Use"and / or an alternate current registration authorising such purchases, if you require or seek scheduled products. Please attach this separately.

CREDIT TERMS AND CONDITIONS

Boian Surgical Pty Ltd. reserves the right to charge interest, at court interest rate, from the date of invoice. Boian Surgical Pty Ltd., further reserves the right to claim reimbursement of all out of pocket expenses plus collection fees, solicitors fees and all legal costs associated with the collection of any outstanding accounts.

RETURN OF GOODS POLICY

Goods will only be accepted for return and credit when prior approval has been given. Application for return of goods must be made within fourteen ( 14 ) days of invoice date and the invoice number be quoted.

Application for credit due to short shipment, damage or oversupply, must be made within seven ( 7 ) days of invoice date. Goods for return are to be re-packaged, in order to protect the goods from damage while in transit.

Acceptance of goods returned for credit does not signify agreement to issue a credit note. A credit note may be issued only after the goods have been inspected and found to be in a satisfactory condition. Special purchases are not returnable.

Any concerns regarding the expiry period remaining on goods received must be communicated to Boian Surgical Pty Ltd. within fourteen ( 14 ) days of invoice date. Credit applications due to incorrectly ordered items by the client will attract a 10% re-stocking fee.

Authorisation and Guarantee

I / We wish to apply for a credit account with Boian Surgical Pty Ltd.

I / We have read the Terms and Conditions of Trade and herby agree to adhere to the said conditions and also warrant that the above information is true and correct.

Print Name: Position:

Signed:Date: