Membership Application: Pool Builders
W EU S EH RN RA AL SO TC AU ST A V Q IUTE E T NAUS S O LTRA IL IIA N D S W I M M I N G P O O L & S PA A S S O C I AT I O N
Business Contact Details
Legal Entity: Trading Name: ABN:
QBCC Licence Number:
Year Commenced:
No. of Employees:
Business Address (Head Office): Suburb:
State: Postcode:
Postal Address (if different from above): Suburb:
State: Postcode:
Phone Number:
Fax Number:
Business Website Address: Business Email: Director’s (1) Full Name:
QBCC Licence No. (if any):
Email: Mobile: QBCC Licence No. (if any):
Director’s (2) Full Name:
Email: Mobile: Type of Business (please tick ) Builder/Installer
Pool Renovator Landscaping
Concrete Pools
Fibreglass Pools
Commercial Pools
Vinyl Lined Pools
Modular Pools
How did you hear about SPASA QLD? Insurance Policies of Applicant (please tick and attach policy certificate) Public Liability
Value $
Insurer’s Name:
Contract Works
Value $
Insurer’s Name:
Nomination by an existing SPASA member (if you are unable to obtain nomination from an existing member, please leave blank and forward your application to the SPASA QLD office for review) Name:
Business Name:
Signed:
Contact Phone Number:
W EU S EH RN RA AL SO TC AU ST A V Q IUTE E T NAUS S O LTRA IL IIA N D S W I M M I N G P O O L & S PA A S S O C I AT I O N
References List two (2) current Trade Credit References (from Suppliers within the Pool & Spa Industry) for the Applicant Business 1. Name
Person to Contact
Phone:
Email:
Fax:
2. Name
Person to Contact
Phone:
Email:
Fax:
List two (2) past Clients of the Applicant Business (from whom information regarding past services can be obtained) 1. Name
Person to Contact
Phone:
Email:
Fax:
2. Name
Person to Contact
Phone:
Email:
Fax:
Please tick Rate incl. GST
Annual Membership Fees
Pool Builder/Renovator/Installer - annual turnover zero to $250,000.00 $1,100.00 - annual turnover $250,000.00 to $1,000,000.00 $2,750.00 - annual turnover $1,000,000.00 to 3,000,000.00 $4,400.00 - annual turnover $3,000,000.00 to 5,000,000.00 $6,050.00 - annual turnover $5,000,000.00 plus $7,700.00 Please note: A (once only) non-refundable application fee of $110.00 is payable with all applications.
A pro-rata fee is payable calculated on the number of months remaining from January to December.
Payment Details Direct deposit: SPASA QLD BSB: 484-799; A/C: 162283441 Suncorp NOTE: Use your Trade name as reference Visa Card no:
Mastercard Expiry:
/
Money order, bank or personal cheque
Amount $
Cardholders name:
Signature:
W EU S EH RN RA AL SO TC AU ST A V Q IUTE E T NAUS S O LTRA IL IIA N D S W I M M I N G P O O L & S PA A S S O C I AT I O N
Declarations 1. Have you or any director or person in charge of your business ever been declared Bankrupt or involved in a company which had its affairs placed under the control of another due to the financial circumstances of the company including an application to wind up, the appointment of an administrator, liquidator or receiver? No Yes (if yes, please attach full details) 2. Have you or any director or person in charge of your business ever been fined, disqualified or suspended by the QBCC or QCAT over the past five years? No Yes (if yes, please attach full details) I/We agree to support the aims and objectives of SPASA QLD and to abide by the Association Rules, Regulations, ByLaws and Code of Ethics. I/We understand that the submission of my/our payment does not mean acceptance for, or any other entitlement of membership of SPASA QLD, and until a decision is relayed to me/us in writing, I/we are not entitled to use the SPASA QLD Logo or in any way indicate that I/we am/are a member of SPASA QLD. The information provided in this Application, is for the purpose of a Membership Application only, and I/we herein authorise the Association to make any Credit (or other Commercial inquiry) as may be sufficiently necessary for the purpose of assessment for Membership, provided that such information is obtained and remains strictly “Private & Confidential”. I/We declare that all the information contained herein is true and correct. Dated this
day of
20
Signed (Director/Principal/Manager):
Check List and Additional Information Are all sections of the Application filled out, and, are all required attachments (as applicable) enclosed? Certificate of Business Registration in Queensland
Contract Works Insurance details
Certificate of Incorporation of a Company
Building License for the Class of Work being undertaken
Product/Service brochures (or, descriptions)
Standard Engineers Plans for Pool Construction/Installation
Public Liability Insurance details
Non-refundable APPLICATION FEE of $110.00
Send your completed application together with your insurance documents to one of the following: Post to: The Swimming Pool and Spa Association of QLD (SPASA) PO Box 2123, FORTITUDE VALLEY QLD 4006 Scan & email to: info@spasa.com.au Fax to: (07) 3252 6700 PHONE: (07) 3252 6777