Supplier Information and Authority Form

Mareeba Shire Council's payment terms are the period ending twenty-five (25) business days after receipt of the invoice, unless specified differently in a Contract Document. The Standard Terms and Conditions can be viewed on Council's website here.

Supplier Information

Legal Name *Company name, Trust name or individual as it appears on your ABN

Business Name *Name as it appears on invoice

Postal Address *

Primary Phone *

Secondary Phone

Email Address *For remittance advice

ABN

Are you registered for GST? *

YesNo

Bank Account Details

Account Name *

BSB *

Account Number

Please note:

Mareeba Shire Council is under no obligation to verify the accuracy of the bank details provided.
Mareeba Shire Council will take no responsibility for any delay in payment or errors due to factors outside reasonable control of Mareeba Shire Council, including but not limited to delays or errors in the banking system or error in the account details provided.
Any future changes in bank particulars will be notified immediately to Mareeba Shire Council in writing to the above postal or email address.

Purchasing Details

Email Address *For receiving Purchase Orders

Supplier Declaration

I declare that I have read and accepted the Standard Terms and Conditions of Mareeba Shire Council which are available on the Council's website. Where Suppliers have executived an alternative contract, the Supplier is bound by the Terms and Conditions of that Contract. *

I declare that the above details I have provided are true and correct. Mareeba Shire Council does not take responsibility for the supply of incorrect information. *

Applicant Name *

Position

Applicant Signature *

Draw signature|Type signatureClear

Date *

Privacy Notice: Mareeba Shire Council is collecting your personal information in accordance with the Local Government Act 2009 in order to process your application. The information will only be accessed by authorised Council employees. Your information will not be given to any other person or agency unless you have given us permission or we are required by law.