Are you already a BioFloral customer and would like to apply for a credit line?

Please complete all the fields below and return the form to us by clicking on the SEND button. Please note that certain criteria apply to obtaining a credit line. Upon receipt of your form, our customer service team will validate your eligibility and contact you as soon as possible.

BioFloral Est Application for credit line

GENERAL INFORMATION

Billing address
Billing address
City
Province/State
Postal/Zip
Country

APPLICANT INFORMATION

Name
Name
First
Last

BANK REFERENCES

SUPPLIERS’ REFERENCES

3 references requested

OVERDUE ACCOUNTS

Interest of one percent (1%) per month, twelve percent (12%) per year will be added on any amount due from the 31st day of delivery. All unpaid merchandise remains the property of BioFloral inc. until payment is completed.

By signing this form, I authorize BioFloral to obtain or exchange information with any information agent or credit company for reference and credit checks.

By entering your name here, you agree to use an electronic signature and agree that this has the same legal value as a handwritten signature.

PERSONAL GUARANTEE

I, the undersigned, hereby stand jointly and severally surety for the company mentioned above for the respect and fulfillment of all its obligations including if applicable, the reimbursement or payment of any sum of money, in capital, interest and fees) to BioFloral inc. In connection with this contract,  I expressly waive the benefits of division and discussion.

By entering your name here, you agree to use an electronic signature and agree that this has the same legal value as a handwritten signature.

By refusing to complete and sign this section, you agree that no line of credit will be granted to you.