OPEN AN ACCOUNT

Interested in working with Logic Fresh Direct?

Complete our account application and tell us a little about your business. A member of our team will review your information and contact you to discuss your floral needs.

Please complete all fields. Thank you.

Legal Business Name

DBA (if applicable):

Tax ID / EIN:

Business Structure:

Years in Business:

Website:

Billing Address:

City:

State

Zip Code

Country

Shipping Address is the same as Billing Address

Shipping Address (if different):

City:

State

Zip Code

Country

Full Name

Position / Title

Email:

Office Phone

Mobile Phone

Full Name

Email:

Phone

Preferred Payment Reminder Email (if different):

Preferred Freight Forwarder:

Trucking Company

Delivery Hours (Local Time):

From

To

Special Shipping Instructions / Delivery Notes:

Airport for Pickup / Delivery:

Receiving Contact (if different)

Receiving Phone

After Hours Contact

Dock / Gate Information

After Hours Phone

Appointment Required

Yes No

If Yes, Please Specify

Please provide three (3) trade references.

Company Name Contact Name Phone Email Relationship

Contact Name

Phone

Email

Relationship (Supplier / Customer)

Years Doing Business

Reference 2.

Company Name Contact Name Phone Email Relationship

Contact Name

Phone

Email

Relationship (Supplier / Customer)

Years Doing Business

Reference 3.

Company Name Contact Name Phone Email Relationship

Contact Name

Phone

Email

Relationship (Supplier / Customer)

Years Doing Business

I certify that the information provided in this application is true and complete. I authorize Logic Fresh Direct, Inc. to verify the information provided and to obtain credit information as necessary. I have read and agree to the Payment Methods & Terms and the Credits & Claims Policy.

Printed Name

Title

Date

Let’s grow together.