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Buyer Application
Fuel Surcharge
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Flower Galleries
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ADDRESS
Billing
Contact
Address
City
State
Zip
Country
Phone
Fax
Shipping ( if not same as Billing)
Company
Address
City
State
Zip
Country
Phone
Fax
Memo
DOCUMENTATION
Additional Documents Submited
Licenses
Application Form
No
Yes
Tax Form 149
No
Yes
State License
No
Yes
Resale Certificate No
Nursery's License No
COMPANY INFORMATION
Company Type
Places of Business
Floral Shop
No
Yes
Gift Company
No
Yes
Other
Store Front
No
Yes
Warehouse Facility
No
Yes
Work out of Home
No
Yes
Web Store
No
Yes
Web Address
Salesman
Credit Limit
Price List
Farm Direct Markup %(i.e. 40.00)
Show Farms
No
Yes
Allow Direct PO
No
Yes
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