A confirmation of your order will be emailed to you. This confirmation is subject to approval from our Credit Department. It can take up to two weeks to process your credit, depending on the response time of your suppliers named below. If you need your bags sooner, please consider paying for your initial order via Credit Card or PayPal Account. Thank you.
Date:
DUNS:
Amount of Credit Requested:
Tax ID:
Company:
Billing Address:
City:
State:
Zip:
Shipping is the same as Billing address
Other delivery instructions being sent via email
Shipping is different than Billing address
Shipping Address:
City:
State:
Zip:
Contact:
Phone:
Cell:
Fax:
Email:
Proprietorship
Partnership
Corporation
State of Incorporation:
Year started:
************************************************************************************************************************ Proprietorships and Partnerships fill-out section below. Corporations skip to next section
Required Fields for proprietorships and partnerships
Principal Name:
SSN:
Phone:
Address:
Principal Name:
SSN:
Phone:
Address:
All Applicants fill-in the following section:
BANK REFERENCE
Name:
Contact person:
Account number:
TRADE REFERENCES We require three current trade references
Name:
Credit Line:
Contact:
Phone:
Name:
Credit Line:
Contact:
Phone:
Name:
Credit Line:
Contact:
Phone:
The applicant is authorized to submit this application. The applicant hereby authorizes the credit grantor to verify without liability, the statements contained herein. If credit is extended, the applicant agrees to abide by the terms and conditions of sales set forth by credit grantor. Applicant agrees to pay all reasonable collection costs, attorney fees and court costs incurred if an overdue account is assigned for collection, or if a suit is initiated by credit grantor. Applicant understands that there is a 1.5% per month late charge for any past due invoices. Applicant has read, understands, and agrees to the Terms of Sale as described on the top of this application. The applicant agrees that any litigation which may occur will be held in the state of North Carolina. By submitting this application over the internet, applicant agrees that the typed signature below constitutes an electronic signature. Alternately, this application can have a written signature and be faxed or mailed to the number or address above. Roots, Inc. dba ecoroot warranties its products for a period of 90 days, and expressly limits its liability to the cost, repair or replacement of the bag. Applicant understands that there is a 2% Destroy-in-Field Allowance built into the wholesale cost of the product and that only defectives in excess of 2% of a particular shipment will be repaired or replaced at the company's option. By submitting this application, applicant acknowledges and agrees to the above.
Authorized Signature:
Please type name. If submitting by fax or mail, also sign next to typed name
Title:
Date:
SHIPPING PREFERENCES : Unless specified below, we use Fed Ex ground, and bill your account at our cost. However, if you would prefer to use your own shipper and have them bill you, please enter the following information:
My Shipper Information: Shipper Name: Shipping Account Number:
If you have decided to use PayPal Express or a credit card for your opening order,please check here.
CREDIT LINE REQUESTED:
Comments:
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