Become a Customer

We welcome your interest in buying from our company and are looking forward to a working relationship with you. However, before we do business, we will need for you to complete the following form. Once we receive your completed application, we will establish you as a C.O.D. client. After you have made at least one purchase on a C.O.D. basis, you can apply for a credit account.

We appreciate your cooperation and look forward to receiving your application!

Firm Name:

Parent Company Name:

Street address:

City:

State:

Zip:

County:

Billing address:

City:

State:

Zip:

County:

Phone:

Mobile:

Fax:

Legal status: (please check one)
Proprietorship	Partnership	Corporation	in
Year established:		At present location since:
Federal ID#:		Sales Tax#:

Property is: Owned Leased		from whom?:

Nature of business: (i.e. Retail, Landscape, etc.)

Company website? Yes No		Website address:
Company Contact Email:

Florida Law requires anyone buying plants from a Florida plant producer to comply with the Florida License & Bond Law. (See the end of the application for further information on the License & Bond Law.) Please provide the following information:
Agriculture license #:	Florida Agriculture Bond#:
Amount of Bond: $	Date of Bond inception:

Please list current officers' or owners' names below:
Name #1:	Title:	Birthdate:
Address:		Home Phone:

Name #2:	Title:	Birthdate:
Address:		Home Phone:

Name #3:	Title:	Birthdate:
Address:		Home Phone:

Name of person signing checks:
Social Sec.#:	Birthdate:
Drivers Lic.#:	Issued in
Address:	Home phone:

Accounts Payable contact information:
Name:	Phone:	Fax:

Trade References: (Please give the names of two green-goods suppliers from whom you are currently buying.)
Reference #1:	Contact:
Address:	Phone:

Reference #2:	Contact:
Address:	Phone:

TERMS AND CONDITIONS OF SALE: All sales are cash unless credit arrangements are made in advance. Once a credit application has been processed and credit has been granted the following terms apply. All credit sales are on a 30-day net due basis. Finance charges are assessed monthly at the annual rate of 18%. All payments are applied to finance charges first and then the oldest balance. Any account 45 days past due will automatically be placed on COD unless other payment arrangements have been made in advance. Payments received on past due accounts will continue to be credited against finance charges first and then oldest balance. If an account remains in an over 30 day status for three consecutive months credit terms are revoked. There will be a $30 service charge on all returned checks, plus cost of collection, if any.

ORDERING: Most orders are taken over the phone or placed by fax. Our sales people do their best to accurately describe the condition of the plants. There are minimum orders depending on the distance to the delivery site.

Does your firm require purchase orders? Yes No

FLORIDA STATE LAW REQUIRES: All dealers in agricultural products covered by the Florida Agricultural License and Bond Law, Sections 604.15 - 604.30, Florida Statutes, who buy or receive such products from Florida producers, their agents or representatives, on other than cash currency basis must be licensed and bonded. (Citrus, tobacco, sugar cane & tropical foliage are not covered by the law.)

If you operate in a manner which would require your compliance with this law and are not presently licensed and bonded, you should contact: Bureau of License and Bond, Department of Agriculture and Consumer Services, Mayo Building, Room 418, Tallahassee, FL 32301. Their phone number is (850) 488-4101.

Aperisys Internet, Inc.