Subject: River Valley Floral - New Customer Documents
 
Hello New Customer. 
 
Thank you for thinking of us for your floral needs. 
 
I am including the required information to establish a new account.  This includes a resale certificate affidavit and a credit card authorization form.  It is our policy for new customer accounts that the first order must be secured with a credit card prior to shipping.  Please note that new customers have a minimum of 120 days waiting period before a charge account can be established, with approved credit.  Please return the forms and a copy of your driver’s license and your State Sales Tax Permit via fax or mail prior to your first order.  
 
You will be assigned a salesperson, if you have questions we will be glad to assist.  If you have any questions regarding your account please contact me or Lisa at 800-264-1199.  
 
I would like to encourage you to come and visit our new location at 6301 Prairie Drive in Ft. Smith.  If you are interested we can also put you on our email list for specials, please confirm if you would like to be added to our private contact list.  Once again thank you for choosing River Valley Floral we look forward to working with you.
 
Thank you,
 
Barbara Bahn, Office Manager
1-800-452-1199
479-452-2538  or email. barbara@rivervalleyfloral.com

6301 Prairie Drive, Fort Smith, AR 72916 Phone (479) 452-1199 Fax (479) 452-2538

Please provide copy of Resale Tax Permit 

COMPANY NAME: ________________________________________________________________________

DIVISION OF ____________________________________________________________________________

COMPANY ADDRESS:  ____________________________________________________________________

EMAIL ADDRESS _________________________________________________________________________ 

CITY:  ______________________________________________________________________________________

STATE: ____________     ZIP:  ______________________________________________________________ 

BILLING ADDRESS:  _______________________________________________________________________

ZIP:  ________________ BUSINESS PHONE:   ______________________ FAX:  ____________________ 

ACCOUNTS PAYABLE CONTACT: _________________________________________________________

FORM OF BUSINESS:  CORPORATION   □   PARTNERSHIP   □   SOLE PROPRIETOR □    OTHER □ 

NAMES OF OWNERS OR AUTHORIZED OFFICERS: 

NAME: _______________________________________________________________________________________

TITLE: ______________________________________________________________________________________ 

ADDRESS: ________________________________________ CITY: _____________________ ST: _______  

ZIP:  ________________ CELL PHONE:   ______________________ HOME PHONE:______________  

FAX: _________________________________________________________________________________________

DRIVERS LICENSE NUMBER ______________EXPIRATION DATE: ___________ ST: _____ 
 

NAME: ________________________________________________________________________________________

ADDRESS: ____________________________________________________________________________________

ZIP:  ________________ CELL PHONE:   ______________________ HOME PHONE: ___________________ 

FAX: ____________________________________________________________________________________________

EMAIL ADDRESS: ____________________________________________________________________________ 

DRIVERS LICENSE NUMBER ______________________ EXPIRATION DATE: ___________ ST: ______ 

NAME: _________________________________________________________________________________________

 TITLE: ________________________________________________________________________________________

ADDRESS: _______________________________________________________________________________________

CITY: _____________________ ST: _______  

ZIP:  ________________ CELL PHONE:   ______________________ HOME PHONE: ________________________ 

FAX: ______________________________

EMAIL ADDRESS: _______________________________________________________________________________ 

DRIVERS LICENSE NUMBER ______________________ EXPIRATION DATE: ___________ ST: _____ 

CLAIMS POLICY 

The customer must notify their sales representative of any problems with flowers and/or merchandise within twenty-four (24) hours of receipt of merchandise to obtain authorization for claim/return.  No returns with be accepted without authorization.  Please provide the following information during the conversation:

• Invoice Number
• Exact problem with flowers or merchandise

• Notice:  Any and all NSF checks returned to River Valley Floral will carry a $35.00 service charge.
• No Exceptions!

DECLARATION

I/We hereby certify that I/We either hold or am the authorized representative(s) or the holder(s) of Arkansas Sales/Use Tax Permit Number __________________________, or that I/we am a nonresident purchaser or the authorized representative(s) thereof of and hold a similar permit issued by the State of ______, Number ___________; that this is a current and valid permit number; and that I/We regularly engage in the business of reselling the tangible personal property that I/We purchase from River Valley Floral.  I further certify that if any tangible personal property purchased exempt under this certificate is withdrawn from stock or otherwise used and not resold, that I/We will report the tax due under Arkansas Sales/Use Tax Law and Regulations.

Signature __________________________________________________________________________________________  

Title ________________________________________________________________                              

Date________________________________________________________________ 

Signature___________________________________________________________________________________________    

Title ________________________________________________________________                                    

Date ________________________________________________________________

PERSONAL GUARANTEE

 I/We or either of us will individually and/or jointly guarantee full and prompt payment of all indebtedness by

(Firm Name) ______________________________

Individual ______________________________

___________________________________________________________________________________________________                                                              

               Signature,    Title,      Social Security No.                                                          Date___________________

Individual ___________________________________________________________________________________________

               Signature      Title      Social Security No.                                                       Date___________________