Spasa membership application shops service suppliers

Membership Application: Shop, Service & Suppliers

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 (if any):

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: Director’s (2) Full Name:

QBCC Licence No. (if any):

Email: Mobile: Type of Business (please tick ) Consultant  Media  Sub-trade  - Specify:

Pool Shop 

Supplier  Service Technician  Pool Safety Inspector 

How did you hear about SPASA QLD? Percentage the Business deals with consumers:

Percentage the Business deals with Industry:

Describe your Business:

Please provide a copy of your: Certificate of Business Registration or Incorporation of Company Current Professional indemnity Insurance: Policy No:

Underwriter:

Current Public Liability Insurance: Policy No:

Spa Retailer 

Underwriter:

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

List additional trading addresses together with contact details of employees who you would like to receive industry information from SPASA QLD;

Additional Address - 1

Business Address:

Suburb:

State:

1. Name:

Job Title

Email:

Contact Number:

2. Name:

Job Title

Email:

Contact Number:

3. Name:

Job Title

Email:

Contact Number:

Postcode:

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:

2. Name

Person to Contact

Phone:

Email:

Fax:

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:

2. Name

Person to Contact

Phone:

Email:

Fax:

Fax:

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 Types and Products Sold

Please tick  Rate incl. GST

So that we can classify your business appropriately in our various membership listings, please tick at least one of the following products and/or services your business is involved with (you may tick  more than one box).  Consultant

 Shades and Covers

 Spas - Portable

 Fencing Subcontractors

 Pumps and/or Filters

 Copings and Tiles - Subcontractors

 Fencing Suppliers

 Pools - Pre-fabricated Retailer

 Pool Safety Inspection

 Heating - Cooling

 Saunas

 Mobile Pool Services

Other - please specify:

Annual Membership Fees QBCC Licensed (Non-Structural) Shop / Tech / Contractor

- annual turnover up to $250,000 - annual turnover $250,000 to $1,000,000 - annual turnover $1,000,000 to $3,000,000 - annual turnover $3,000,000 to $5,000,000 - annual turnover over $5,000,000

$1,100 $2,750 $4,400 $6,050 $7,700

    

Non-QBCC Licensed Allied Professional - deals with pool builders / installers Pool Shop / Service Technician - 50% for 2nd and subsequent shops Sole Operator Service Tech - sole operator without a Pool Shop Pool Inspection Business - plus $110 pp each additional PSI Pool Safety Inspector (Sole Op) - $110 pp if member in other category

$550 $550 $330 $550 $330

    

Supplier Fees Queensland Supplier

National Supplier

$550 $1,100 $1,650 $2,750 $7,700

    

- annual turnover up to $250,000 - annual turnover $250,000 to $1,000,000 - annual turnover $1,000,000 to $2,000,000 - annual turnover over $2,000,000 - annual turnover (Includes Qld, NSW, Vic, SA & WA)

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 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 cheque 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 authorises the Association to make any Credit (or other Commercial inquiry) as my be sufficiently necessary for the purpose of assessment for Membership, provided that such information is obtained and remains strictly “Private & Confidential” I/We confirm that where required all products have been tested and certified compliant with Australian Standards and codes and evidence of such can be produced on request.

I/We declare that all the information contained herein is true and correct.

Dated this

day of

20

Signed (Director/Principal/Manager):

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:

Check List and Additional Information Are all sections of the Application filled out, and, are all required attachments (as applicable) enclosed?

 QBCC Pool Safety Inspector Licence  Certificate of Business Registration in Queensland,  Product/Service brochures (or, descriptions)

 Professional Indemnity Insurance details  Public Liability Insurance details  QBCC Licence for the Class of Work being undertaken

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