Order Form

APEX CONTACT NAME

Client Order Number

Order Date

Client Contact Name:

Client Company Name

Address 1

Address 2

Address 3

Post Code

Fax No:

Tel No:

E-mail:

Please Select the Trades of Your Order:

Trade 360 DriverBanksmanBricklayerCarpenterCeiling FixerDecoratorDigger DriverDrylinerDumper DriverElectricianForemanGroundworkerHandymanJoinerLabourerPainterPipe FitterPlastererPlumberProject ManagerScaffolderShopfitterShuttererSite ManagerSteel FixerWelderOtherChoose from List

If Other please specify here:

Trade Mate Not ApplicableMate to the Above Trade

Charge Rate (£ per Hour):

Work Details

Health & Safety Requirements

Work Address 1

Work Address 2

Work Address 3

Work Post Code

Reporting To:

Work Tel. No:

Work Mobile:

We confirm that we have understood the details above and that they are to correct and to our satisfaction. We also understand that all operatives will be provided in accordance with Apex Resources Limited Terms and Conditions (please see the latest version in Downloads section of our website):

I Confirm My Order (tick the box to confirm)

Authorised Signatory (Name)

Position

Thank You for placing your order with Apex Resources Limited. Your Account Manager will be back in touch with you shortly to confirm the details.