Business Application & Policy Notice

Transcription

1 Global Organic Specialty Source, Inc McIntosh Rd, Sarasota, Fl Phone (941) (941) Business Application & Policy Notice Date DBA Business Name State Registration # Federal ID# Billing City State Zip Code Business Phone Contact Person Business Type of Business Years Established Length of Time at Above Location Mailing (Same as Billing?) City State Zip Code Street City State Zip Code Are There Multiple Locations? If So Please State the of Each: Estimated Annual Sales PACA License No. Dunn & Bradstreet No. Page 1 of 6

2 Blue Book No. Shipping City State Zip Code Phone Contact Person Special Billing Instructions Owner Information Full Name Social Security# Residence City State Zip Code Home Phone Cell Number Date of Birth / / Driver s License # Expiration Have you ever been involved in a bankruptcy proceeding? Where is the Business organized? Business / Credit References (Please List 3 or More) Does Global Organic Specialty Source, Inc. have the authorization to check credit references? Yes: No: 1) Name 2) Name Page 2 of 6

3 3) Name 4) Name Banking Information Bank Name Contact Person Page 3 of 6

4 Global Organic Specialty Source, Inc McIntosh Rd, Sarasota, Fl Phone (941) (941) DELIVERY ROUTING MAINTENANCE FORM Customer Delivery Information Can your location receive a Tractor/Trailer Combination of 65 feet in length? Yes No Do you have a loading dock? Do you have a forklift? Can you accommodate a pallet delivery? Can you accommodate a Hand Truck? Is the drop-off point located in a residential neighborhood? Is the drop-off point location restricted for trucks? Yes No Is the drop-off point in a gated community? What are your hours for receiving? If yes, access instructions/gate code Driving Directions from Major Highway or Interstate Page 4 of 6

5 Global Organic/Specialty Source, Inc McIntosh Rd, Sarasota, Fl Phone (941) (941) Terms of Payment: 1. COD Check, money order or cash for the driver when delivery of product is received. a. Key-In Drop Lock shipments must have payment waiting for driver in specified location agreed between Globals transportation department and customer. 2. PACA 7 Payment is required for the previous week s invoice, by mail, to driver, or by wire transfer. 3. PACA 10 Payment is required for the earliest invoice in arrears, by mail, to driver, or by wire transfer. 4. Accounts with outstanding balances 14 days over terms will be placed on Credit Hold. Accounts with outstanding balances over 30 days will be assessed late fees in the amount of 1.5% per month to a maximum of 18% per annum by federal regulation law and U.C.C. code. 5. In the event of any changes in responsible parties, the undersigned will notify Global Organic Specialty Source, Inc. in writing, the name, address and phone number of the new responsible party. The terms of this agreement will remain in full force until acknowledged in writing by Global Organic Specialty Source, Inc. ALL INVOICES MUST BE SIGNED AND DATED BY THE CUSTOMER AND DRIVER ACCEPTING THE DELIVERY. Returned Checks: If a check is returned for any reason, a charge of $30.00 will be added to the account. This charge must be included with the replacement check. Credits: Credits will be given as follow; no other method of credit can be accepted. For product returns at the time of delivery: 1. Bring returns to the driver in the original carton for full credit. Do not write/mark on original carton. 2. Credit will be posted to the account when invoice copy is received and Global Organic accepts product. For product returns after driver has left: 1. Our sales department must be contacted within 24 hours of delivery. 2. Call a Global Organic Sales Representative or fax a copy of the invoice with the credits listed in the credit section of the invoice. 3. A Credit Memo number will be issued by the sales department with return instructions. Page 5 of 6

6 4. Global Organic personnel may request as a condition, that the product be returned via our driver at your next scheduled delivery and the credit will be issued after receipt of the product is completed. 5. A credit will be issued to the account when return is finalized. Any credits on an account must be used within 90 days of date of issue. I, the undersigned hereby warrants the above information to be true, and authorize Global Organic Specialty Source, Inc. to investigate the references listed pertaining to my/our credit and financial responsibility. I personally guarantee payment in accordance with Global Organic Specialty Source, Inc. terms of payment. I further agree that should it be necessary for Global Organic Specialty Source, Inc. to initiate any legal proceedings for the collection of any balance due under this account, I agree to pay reasonable attorney s fees, interest, and late fees to be fixed by the court and all costs of the suit. The pricing you receive from us is the exclusive property of Global Organic and is considered confidential. It cannot be reproduced in any manner including but not limited to posting on the Internet, printing to distribute or by . We appreciate your cooperation. I have read and accept the above terms and policies, and attest that I am authorized to sign Signature (required) Date Print Name Signature (required) Date Print Name Page 6 of 6