Roses & More, Inc. | 414 N Sycamore St. | Spokane, WA 99202-4624 | Tel: 509.838.2944 | 800.541.5621 | www.rosesandmoreinc.com
Section I:
CUSTOMER ACCOUNT APPLICATION
[Required for all applicants]
Date _________________
*□ C.O.D. (Immediate payment at time of shipment/delivery) or option to run credit card with each order:
□ Credit Card (# will be secure or call with #) _______________________________________________________
Card Number:
Exp. Date:
Verification Code:
*The Applicant (Company Name), _______________________________________________________________ ,
intends that Roses & More, Inc. (R&M) will rely upon the information submitted in this application and represents that
such information is true and accurate as of date hereof. Applicant hereby gives R&M permission to verify all
information contained herein. If accepted by R&M, this application will become a contract between R&M and
applicant.
*Business Address____________________________________________________________________________
*City _____________________________________________________ *State _______________ *Zip _________
*Billing Address _____________________________________________________________________________
*City _____________________________________________________ *State _______________ *Zip _________
*Business Phone # ____________________________ *Alternative Business Phone # ________________________
*Business Fax #_________________________________ *Cell Phone # __________________________________
*Email Address ______________________________________________________________________________
*Web Site Address ____________________________________________________________________________
*Type of ownership:
□ Sole Proprietor □ Partnership □ LLC □ Corporation □ Non-profit
*Ownership Information:
If a Corporation or Non-profit:
Name:
Address:
Home Phone:
Address:
Home Phone:
President
Vice President
Secretary
Treasurer
Number of Shareholders
If a Sole Proprietorship, Partnership or LLC:
Name:
Social Security #:
*Business Experience:
Ownership established ______________ Number of Employees ______________ Business Hours _____________
Previous business experience ___________________________________________________________________
Owner/Manager’s experience in Floral Industry _____________________________________________________
Office use only:
A/C # ________________ Date ________________ Approved by ________________
Revision 10/13/2014
Page 1 of 5
*Nature of Business (Provide Detailed Description of Principal Products Sold or Services Rendered):
□ Retail Florist □ Mass Market Retailer □ Grower □ Wholesale Florist □ Government Org. □ Interior Design
□ 501(C)3 (Non Profit Org) □ Other (Explain) _________________________________________________________
*Type of Business (Consists of selling):
□ Fresh flowers & plants □ Giftware □ Permanent flowers & plants □ Garden supplies □ Plants
□ Other ___________________________________________________________________________________
__________________________________________________________________________________________
Section II:
MARKETING CONTACT INFORMATION
Please add the following contacts for future communications via:
□ E-mail □ No Thank You
I understand that by providing my contact name, mailing address, telephone number, e-mail address and/or fax, I
consent to receive communications sent by or on behalf of Roses & More, Inc. I also understand that Roses & More,
Inc. will not share my address, telephone number, e-mail address or fax number with others.
Contact Person/Authorized Buyer(s):
E-mail:
Owner:
Flower Buyer(s):
Supply Buyer(s):
Plant Buyer(s):
Accounts Payable:
Section III:
RESALE CERTIFICATE
[For Idaho and Washington customers only.]
•
Idaho State customers must provide a copy of their Idaho Seller’s Permit and Nurseryman’s
License from the Idaho State Department of Revenue with their customer application;
otherwise tax will be applied to outgoing orders.
•
Washington State customers must provide a copy of their Reseller’s Permit from the
Washington State Department of Revenue with their customer application; otherwise tax
will be applied to outgoing orders.
Revision 10/13/2014
Page 2 of 5
Section IV:
APPLICANT SIGNATURE
[Required for all applicants]
Credit Terms and Conditions:
Applicant agrees to pay R&M according to the terms and conditions of R&M’s invoices. Interest shall accrue on all past
due balances of 18% per annum, or at the rate shown on R&M’s most recent invoice or billing statement, whichever is
greater.
If Applicant fails to pay any invoice when due, R&M may terminate this Agreement and declare the balance of the
account immediately due and payable without further notice.
Applicant shall pay all collection agency fees, reasonable attorney fees, and other costs of expenses incurred by R&M to
enforce this Agreement, whether incurred with or without litigation, on appeal, or in bankruptcy or other insolvency
proceedings. Further, Applicant hereby attorns and submits to the jurisdiction of the courts of the State of Washington
in any action for the enforcement or interpretation of this agreement, which shall be governed by the Washington law.
The venue of any such action may be laid in Spokane County, Washington.
*Name of Applicant (Company Name): _______________________________________________________________
*Signature: __________________________________________________________________________________
*Print Name: _________________________________________________________________________________
RETURN APPLICATION INFORMATION
*Required information for application to be processed.
Incomplete applications will not be processed. Please complete all required sections.
Please allow 2-3 business days for your application to be processed.
Please Fax or mail completed application to:
Address: Roses & More, Inc.
414 N. Sycamore St.
Spokane, WA 99202-4624
Fax: 509-624-5329
Revision 10/13/2014
Page 3 of 5
Credit Card Authorization Form
Instructions:
Complete form with credit card information
Sign where indicated
Submit to Samantha Allie in Accounts Receivable Department
Call 509-343-2691 Samantha’s direct line about questions you might have.
Card Information:
*Cardholder Name: _____________________________________________
*Credit Card: _____Visa
_____MasterCard
_____American Express
*Card Number: ________________________________________________
*Expiration Date: ___________
*Security Number: _______(3-4Digits on the back)
*Billing Address: ______________________________________________
*City: _______________________________________________________
*State: __________________________
*Zip Code: _______________
*Country: ____________________________________________________
*Phone Number: ______________________
E-Mail Address: _______________________________________________
I authorize Roses & More Inc. to charge my credit card as invoices are posted to my
account and for any balances that may become past due.
*Signature: ________________________________________________
*Printed Name: _____________________________________________
*Date: __________________
Revision 10/13/2014
Page 4 of 5
TERMS & POLICIES STATEMENT
[Keep this page for your records]
Payment of all invoices is due upon shipment or delivery unless a credit account is established. Finance
charges will be automatically assessed on all delinquent accounts at a rate of 1.5% per month (ANNUAL
PERCENTAGE RATE 18%) with a minimum charge of $1.00 per month. No exceptions will be made.
PAST DUE ACCOUNTS WITH BALANCES OVER 60 DAYS WILL BE C.O.D WITHOUT FURTHER
NOTICE.
Unless other arrangements are made, the following is Roses & More, Inc.’s policy on accounts that are past
due:
1) If balances on your account are over sixty days, orders will be sent out on a C.O.D basis. When the
account is brought current, after six months you may reapply for credit.
2) If balances on your account are over ninety days, your account will be referred to our attorney. In the
event your account goes to our attorney, the attorney fees paid by Roses & More Inc. will be added to
your account.
If a check is returned to us due to insufficient funds, we will charge $35.00 along with the amount of the
NSF check back to your account, payable in cash, cashier check or credit card only, also no orders will be
sent out until the NSF is cleared from the account. Any customer presenting two dishonored checks within
one year will be subject to cash or credit card payments only and limitations on future purchases.
Please inspect all items upon arrival. All credit requests must be submitted by e-mail within 48 hrs
after receiving product. Send your credit request to credit@rosesandmoreinc.com. Failure to
send the request via email will result in denial of credit without notice. In addition the e-mail
must contain a picture(s) of the product you’re requesting credit for and the invoice number for proof of
purchase. Check your invoice to make sure the exact items are listed (many times people request credit on
product that isn’t ours).Sales staff and drivers cannot authorize credit. The credit department will review
your request and within five (5) days respond informing you if the credit was approved, denied, or prorated.
At that time you will be notified if the product is to be returned or destroyed. All our drivers carry cell
phones for their use. Drivers will randomly make quality checks by taking pictures to insure accurate
deliveries and quality control. For Hard Goods, Plants, Design product you must follow the same
procedures. If something is broken a picture(s) of the damaged product in the box or container it came in
must be e-mailed to credit@rosesandmoreinc.com within 48 hours from the time of delivery. A
restocking fee may apply, but will not apply to defective merchandise or errors in our shipping. All return
items are to be returned in the box or container they were delivered in on the next available truck. Credit
will not be issued until the return product is received and check by Roses & More Inc.
Roses & More Inc. is not responsible for damaged product shipped common carrier.
Roses & More does not provide cash refunds.
Roses & More, Inc. accepts cash, business checks, money orders, and the following credit cards: VISA,
MasterCard and American Express as form of payment.
Prices are subject to change and all shipments will be invoiced at the prevailing price. Price quotes will be
available at time of order. Special Order Requests may require a deposit at time the order is placed.
Use of your account signifies acceptance with all of the above policies.
Revision 10/13/2014
Page 5 of 5