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1
General Information
2
Responsible Parties
3
Terms and Conditions of Sale
4
Payment Information
5
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BECOME A CLIENT — ECUAMIA FLOWERS
1. GENERAL INFORMATION
Last
First
Title
Name of Business
Federal Tax Number
Trade Name / DBA
Phone of Business
Email
Address
City
State
Zip
Phone (auto-filled)
In Business Since
Legal Form
Resale Tax Cert. #
Buyer First
Buyer Last
Buyer Email
Accounts Payable First
Accounts Payable Last
AP Email
2. RESPONSIBLE PARTIES
Type
First Name
Last Name
Phone
Address
City
State / Zip
Banking Reference
Bank Name
Account #
Phone
Officer
Address
State
Zip
Business References
Company 1
Phone
Contact
Email
3. TERMS AND CONDITIONS OF SALE
Terms of credit are COD. All accounts not paid within terms will be considered delinquent. A service charge of 1.5% per month (18% per annum) will be charged to all past due accounts. All quality issues must be reported by phone within 48 hours of receipt of flowers. In the event of non-payment, a collection fee of 33 1/3 percent will be added to the total amount due.
Name
Phone
Email
Date 2026-06-01
Signature
Co-signer 1
Phone
Email
Date 2026-06-01
Co-signer 2
Phone
Email
Date 2026-06-01
☐I hereby authorize the terms and conditions of sale.
