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New Account Form

Contact Name *
Contact Name
Delivery Address *
Delivery Address
Billing Address *
Billing Address
Accounting Contact
Accounting Contact
(If different from above)
Would you like your invoices emailed to you? *
Business/Office Phone *
Business/Office Phone
Cell Phone *
Cell Phone
Preferred Method of Payment *
Please select one.
Preferred Delivery Day(s) *
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.)
I have read, understood, and agree to the terms and conditions listed above.