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Home
About
The Cause
The Farms
Order Produce
Blog
Contact
Family Farmed Food
New Account Form
Buisness/Account Name
*
Contact Name
*
First Name
Last Name
Delivery Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Billing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Accounting Contact
(If different from above)
First Name
Last Name
Email Address
*
Would you like your invoices emailed to you?
*
Yes
No
Business/Office Phone
*
(###)
###
####
Cell Phone
*
(###)
###
####
Preferred Method of Payment
*
Please select one.
Cash
Check
Credit
Preferred Delivery Day(s)
*
Mondays
Wednesdays
Thursdays
Fridays
Delivery Hours (Be Specific)
*
Delivery Instructions
*
Terms and Conditions
I agree to submit the full invoice amount within 15 days of receipt of the produce. (Failure to pay the full invoice amount within 15 days of receipt will result in a 10% late fee added each week beginning on the 3rd week and continuing until the 5th week. Upon the 6th week of no payment the debt will be submitted to a debt collection agency.) I understand that I have the right to inspect and certify each produce item I receive is in good condition. (Any requests for refunds or exchanges made after signed receipt of the produce is at the full discretion of Food Roots. Approved requests for refunds or exchanges requires, but is not limited to: photo evidence, a full description of what is wrong with the produce and must be received within 24 hours of the initial delivery.)
Electronic Signature
*
I have read, understood, and agree to the terms and conditions listed above.
Thank you!
