Application for Invoice Billing
Mobile Version: https://goo.gl/forms/gE2DRZEV8K0uyu1f2

Please complete for businesses that require invoice billing. Upon approval of this application a representative will contact to set up service.

Farm Fresh Carolinas bills in advance for 4 week periods. Invoices may be paid by a credit card on file, or a business check. All invoices are due within 7 days of receipt. Businesses may skip or cancel service with notice by the Sunday prior to the next scheduled delivery. Any undelivered pre-paid deliveries are fully refundable. Our office will provide a current W-9 upon request.
Email address *
Company Name *
Your answer
Delivery Address (Please include City, State, & Zip) *
Your answer
Contact Name *
Your answer
Contact Phone Number *
Your answer
Email Address to Send Invoices to *
Your answer
Number of Office Employees at Delivery Location
Tell us about your office and which delivery option you were considering.
Your answer
Are in interested in our Wellness Program in which we can deliver to your office employees? This program is at no cost to the employer and saves your employees 5% off each subscription produce delivery.
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