{"id":1584,"date":"2023-11-07T11:00:47","date_gmt":"2023-11-07T16:00:47","guid":{"rendered":"https:\/\/biofloral.ca\/demande-dune-ligne-de-credit\/"},"modified":"2025-10-09T16:53:21","modified_gmt":"2025-10-09T20:53:21","slug":"apply-for-a-credit-line","status":"publish","type":"page","link":"https:\/\/biofloral.ca\/en\/apply-for-a-credit-line\/","title":{"rendered":"Apply for a credit line"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;10px||32px|||&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;2560px&#8221; custom_padding=&#8221;||14px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; header_font=&#8221;Open Sans|700|||||||&#8221; header_text_color=&#8221;#000000&#8243; header_font_size=&#8221;22px&#8221; header_line_height=&#8221;1.3em&#8221; custom_margin=&#8221;||4px|||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1><b><span lang=\"EN-CA\">Are you already a BioFloral customer and would like to <span style=\"color: 00b20f;\">apply for a credit line?<\/span><\/span><\/b><\/h1>\n<p>[\/et_pb_text][et_pb_divider divider_weight=&#8221;2px&#8221; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;4%&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; color=&#8221;#00B20F&#8221; sticky_enabled=&#8221;0&#8243;][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row make_equal=&#8221;on&#8221; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;2560px&#8221; custom_margin=&#8221;|auto|12px|auto||&#8221; custom_padding=&#8221;2px||27px|||&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Open Sans||||||||&#8221; text_text_color=&#8221;#58585a&#8221; text_font_size=&#8221;16px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span lang=\"EN-CA\">Please complete all the fields below and return the form to us by clicking on the <\/span><span style=\"color: 00b20f;\"><b><span lang=\"EN-CA\">SEND<\/span><\/b><\/span><span lang=\"EN-CA\"> 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.<\/span><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;RGBA(255,255,255,0)&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_stops=&#8221;rgba(255,255,255,0) 0%|#ffffff 100%&#8221; custom_margin=&#8221;0px||0px||false|false&#8221; custom_padding=&#8221;0px||73px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; max_width=&#8221;2560px&#8221; custom_margin=&#8221;-35px|auto||auto|false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_code _builder_version=&#8221;4.19.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_67_container\" data-token=\"8a59ed9914b7f9d4912dd512cc8718e9\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_applycreditline\" data-token=\"8a59ed9914b7f9d4912dd512cc8718e9\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">BioFloral Est Application for credit line<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"67\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_67\" id=\"frm_hide_fields_67\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"applycreditline\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_67\" name=\"frm_submit_entry_67\" value=\"e30bc754c5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/1584\" \/><div id=\"frm_field_2398_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">GENERAL INFORMATION<\/h3>\r\n\r\n\r\n<div id=\"frm_field_2399_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_three_fourths\">\r\n    <label for=\"field_lv7xb33\" id=\"field_lv7xb33_label\" class=\"frm_primary_label\">Company name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_lv7xb33\" name=\"item_meta[2399]\" value=\"\"  data-sectionid=\"2398\"  data-reqmsg=\"Company name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2400_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_gk1mp33\" id=\"field_gk1mp33_label\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_gk1mp33\" name=\"item_meta[2400]\" value=\"2026\/09\/20\"  readonly=\"readonly\"  data-sectionid=\"2398\"  maxlength=\"10\" data-frmval=\"2026\/09\/20\" data-reqmsg=\"Date cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3099_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <div  id=\"field_fdrc7_label\" class=\"frm_primary_label\">Billing address\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <fieldset aria-labelledby=\"field_fdrc7_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tBilling address<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_3099-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_fdrc7_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tBilling address\t<\/label>\n\t\t<input type=\"text\" id=\"field_fdrc7_line1\" value=\"\" name=\"item_meta[3099][line1]\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_3099-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_fdrc7_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tBilling address\t<\/label>\n\t\t<input type=\"text\" id=\"field_fdrc7_line2\" value=\"\" name=\"item_meta[3099][line2]\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_3099-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_fdrc7_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_fdrc7_city\" value=\"\" name=\"item_meta[3099][city]\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_3099-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_fdrc7_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tProvince\/State\t<\/label>\n\t\t<input type=\"text\" id=\"field_fdrc7_state\" value=\"\" name=\"item_meta[3099][state]\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\" \/>\n\t<div class=\"frm_description\">Province\/State<\/div><\/div>\n<div id=\"frm_field_3099-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_fdrc7_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tPostal\/Zip\t<\/label>\n\t\t<input type=\"text\" id=\"field_fdrc7_zip\" value=\"\" name=\"item_meta[3099][zip]\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Postal\/Zip<\/div><\/div>\n<div id=\"frm_field_3099-country_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_fdrc7_country\" class=\"frm_screen_reader frm_hidden\">\n\t\tCountry\t<\/label>\n\t\t\t<select name=\"item_meta[3099][country]\" id=\"field_fdrc7_country\"  data-sectionid=\"2398\"  data-reqmsg=\"Billing address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Billing address is invalid\" aria-invalid=\"false\"   autocomplete=\"country-name\">\n\t\t\t<option value=\"\" class=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Afghanistan\" data-code=\"AF\">Afghanistan<\/option><option  value=\"Aland Islands\" data-code=\"AX\">Aland Islands<\/option><option  value=\"Albania\" data-code=\"AL\">Albania<\/option><option  value=\"Algeria\" data-code=\"DZ\">Algeria<\/option><option  value=\"American Samoa\" data-code=\"AS\">American Samoa<\/option><option  value=\"Andorra\" data-code=\"AD\">Andorra<\/option><option  value=\"Angola\" data-code=\"AO\">Angola<\/option><option  value=\"Anguilla\" data-code=\"AI\">Anguilla<\/option><option  value=\"Antarctica\" data-code=\"AQ\">Antarctica<\/option><option  value=\"Antigua and Barbuda\" data-code=\"AG\">Antigua and Barbuda<\/option><option  value=\"Argentina\" data-code=\"AR\">Argentina<\/option><option  value=\"Armenia\" data-code=\"AM\">Armenia<\/option><option  value=\"Aruba\" data-code=\"AW\">Aruba<\/option><option  value=\"Australia\" data-code=\"AU\">Australia<\/option><option  value=\"Austria\" data-code=\"AT\">Austria<\/option><option  value=\"Azerbaijan\" data-code=\"AZ\">Azerbaijan<\/option><option  value=\"Bahamas\" data-code=\"BS\">Bahamas<\/option><option  value=\"Bahrain\" data-code=\"BH\">Bahrain<\/option><option  value=\"Bangladesh\" data-code=\"BD\">Bangladesh<\/option><option  value=\"Barbados\" data-code=\"BB\">Barbados<\/option><option  value=\"Belarus\" data-code=\"BY\">Belarus<\/option><option  value=\"Belgium\" data-code=\"BE\">Belgium<\/option><option  value=\"Belize\" data-code=\"BZ\">Belize<\/option><option  value=\"Benin\" data-code=\"BJ\">Benin<\/option><option  value=\"Bermuda\" data-code=\"BM\">Bermuda<\/option><option  value=\"Bhutan\" data-code=\"BT\">Bhutan<\/option><option  value=\"Bolivia\" data-code=\"BO\">Bolivia<\/option><option  value=\"Bonaire, Sint Eustatius and Saba\">Bonaire, Sint Eustatius and Saba<\/option><option  value=\"Bosnia and Herzegovina\" data-code=\"BA\">Bosnia and Herzegovina<\/option><option  value=\"Botswana\" data-code=\"BW\">Botswana<\/option><option  value=\"Bouvet Island\" data-code=\"BV\">Bouvet Island<\/option><option  value=\"Brazil\" data-code=\"BR\">Brazil<\/option><option  value=\"British Indian Ocean Territory\" data-code=\"IO\">British Indian Ocean Territory<\/option><option  value=\"Brunei\" data-code=\"BN\">Brunei<\/option><option  value=\"Bulgaria\" data-code=\"BG\">Bulgaria<\/option><option  value=\"Burkina Faso\" data-code=\"BF\">Burkina Faso<\/option><option  value=\"Burundi\" data-code=\"BI\">Burundi<\/option><option  value=\"C&ocirc;te d&#039;Ivoire\">C&ocirc;te d&#039;Ivoire<\/option><option  value=\"Cambodia\" data-code=\"KH\">Cambodia<\/option><option  value=\"Cameroon\" data-code=\"CM\">Cameroon<\/option><option  value=\"Canada\" data-code=\"CA\">Canada<\/option><option  value=\"Cape Verde\" data-code=\"CV\">Cape Verde<\/option><option  value=\"Cayman Islands\" data-code=\"KY\">Cayman Islands<\/option><option  value=\"Central African Republic\" data-code=\"CF\">Central African Republic<\/option><option  value=\"Chad\" data-code=\"TD\">Chad<\/option><option  value=\"Chile\" data-code=\"CL\">Chile<\/option><option  value=\"China\" data-code=\"CN\">China<\/option><option  value=\"Christmas Island\" data-code=\"CX\">Christmas Island<\/option><option  value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option  value=\"Colombia\" data-code=\"CO\">Colombia<\/option><option  value=\"Comoros\" data-code=\"KM\">Comoros<\/option><option  value=\"Congo\">Congo<\/option><option  value=\"Cook Islands\" data-code=\"CK\">Cook Islands<\/option><option  value=\"Costa Rica\" data-code=\"CR\">Costa Rica<\/option><option  value=\"Croatia\" data-code=\"HR\">Croatia<\/option><option  value=\"Cuba\" data-code=\"CU\">Cuba<\/option><option  value=\"Curacao\" data-code=\"CW\">Curacao<\/option><option  value=\"Cyprus\" data-code=\"CY\">Cyprus<\/option><option  value=\"Czech Republic\" data-code=\"CZ\">Czech Republic<\/option><option  value=\"Denmark\" data-code=\"DK\">Denmark<\/option><option  value=\"Djibouti\" data-code=\"DJ\">Djibouti<\/option><option  value=\"Dominica\" data-code=\"DM\">Dominica<\/option><option  value=\"Dominican Republic\" data-code=\"DO\">Dominican Republic<\/option><option  value=\"East Timor\" data-code=\"TL\">East Timor<\/option><option  value=\"Ecuador\" data-code=\"EC\">Ecuador<\/option><option  value=\"Egypt\" data-code=\"EG\">Egypt<\/option><option  value=\"El Salvador\" data-code=\"SV\">El Salvador<\/option><option  value=\"Equatorial Guinea\" data-code=\"GQ\">Equatorial Guinea<\/option><option  value=\"Eritrea\" data-code=\"ER\">Eritrea<\/option><option  value=\"Estonia\" data-code=\"EE\">Estonia<\/option><option  value=\"Ethiopia\" data-code=\"ET\">Ethiopia<\/option><option  value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option  value=\"Faroe Islands\" data-code=\"FO\">Faroe Islands<\/option><option  value=\"Fiji\" data-code=\"FJ\">Fiji<\/option><option  value=\"Finland\" data-code=\"FI\">Finland<\/option><option  value=\"France\" data-code=\"FR\">France<\/option><option  value=\"French Guiana\" data-code=\"GF\">French Guiana<\/option><option  value=\"French Polynesia\" data-code=\"PF\">French Polynesia<\/option><option  value=\"French Southern Territories\" data-code=\"TF\">French Southern Territories<\/option><option  value=\"Gabon\" data-code=\"GA\">Gabon<\/option><option  value=\"Gambia\" data-code=\"GM\">Gambia<\/option><option  value=\"Georgia\" data-code=\"GE\">Georgia<\/option><option  value=\"Germany\" data-code=\"DE\">Germany<\/option><option  value=\"Ghana\" data-code=\"GH\">Ghana<\/option><option  value=\"Gibraltar\" data-code=\"GI\">Gibraltar<\/option><option  value=\"Greece\" data-code=\"GR\">Greece<\/option><option  value=\"Greenland\" data-code=\"GL\">Greenland<\/option><option  value=\"Grenada\" data-code=\"GD\">Grenada<\/option><option  value=\"Guadeloupe\" data-code=\"GP\">Guadeloupe<\/option><option  value=\"Guam\" data-code=\"GU\">Guam<\/option><option  value=\"Guatemala\" data-code=\"GT\">Guatemala<\/option><option  value=\"Guernsey\" data-code=\"GG\">Guernsey<\/option><option  value=\"Guinea\" data-code=\"GN\">Guinea<\/option><option  value=\"Guinea-Bissau\" data-code=\"GW\">Guinea-Bissau<\/option><option  value=\"Guyana\" data-code=\"GY\">Guyana<\/option><option  value=\"Haiti\" data-code=\"HT\">Haiti<\/option><option  value=\"Heard Island and McDonald Islands\" data-code=\"HM\">Heard Island and McDonald Islands<\/option><option  value=\"Holy See\">Holy See<\/option><option  value=\"Honduras\" data-code=\"HN\">Honduras<\/option><option  value=\"Hong Kong\" data-code=\"HK\">Hong Kong<\/option><option  value=\"Hungary\" data-code=\"HU\">Hungary<\/option><option  value=\"Iceland\" data-code=\"IS\">Iceland<\/option><option  value=\"India\" data-code=\"IN\">India<\/option><option  value=\"Indonesia\" data-code=\"ID\">Indonesia<\/option><option  value=\"Iran\" data-code=\"IR\">Iran<\/option><option  value=\"Iraq\" data-code=\"IQ\">Iraq<\/option><option  value=\"Ireland\" data-code=\"IE\">Ireland<\/option><option  value=\"Isle of Man\" data-code=\"IM\">Isle of Man<\/option><option  value=\"Israel\" data-code=\"IL\">Israel<\/option><option  value=\"Italy\" data-code=\"IT\">Italy<\/option><option  value=\"Jamaica\" data-code=\"JM\">Jamaica<\/option><option  value=\"Japan\" data-code=\"JP\">Japan<\/option><option  value=\"Jersey\" data-code=\"JE\">Jersey<\/option><option  value=\"Jordan\" data-code=\"JO\">Jordan<\/option><option  value=\"Kazakhstan\" data-code=\"KZ\">Kazakhstan<\/option><option  value=\"Kenya\" data-code=\"KE\">Kenya<\/option><option  value=\"Kiribati\" data-code=\"KI\">Kiribati<\/option><option  value=\"Kosovo\" data-code=\"XK\">Kosovo<\/option><option  value=\"Kuwait\" data-code=\"KW\">Kuwait<\/option><option  value=\"Kyrgyzstan\" data-code=\"KG\">Kyrgyzstan<\/option><option  value=\"Laos\" data-code=\"LA\">Laos<\/option><option  value=\"Latvia\" data-code=\"LV\">Latvia<\/option><option  value=\"Lebanon\" data-code=\"LB\">Lebanon<\/option><option  value=\"Lesotho\" data-code=\"LS\">Lesotho<\/option><option  value=\"Liberia\" data-code=\"LR\">Liberia<\/option><option  value=\"Libya\" data-code=\"LY\">Libya<\/option><option  value=\"Liechtenstein\" data-code=\"LI\">Liechtenstein<\/option><option  value=\"Lithuania\" data-code=\"LT\">Lithuania<\/option><option  value=\"Luxembourg\" data-code=\"LU\">Luxembourg<\/option><option  value=\"Macao\" data-code=\"MO\">Macao<\/option><option  value=\"Macedonia\" data-code=\"MK\">Macedonia<\/option><option  value=\"Madagascar\" data-code=\"MG\">Madagascar<\/option><option  value=\"Malawi\" data-code=\"MW\">Malawi<\/option><option  value=\"Malaysia\" data-code=\"MY\">Malaysia<\/option><option  value=\"Maldives\" data-code=\"MV\">Maldives<\/option><option  value=\"Mali\" data-code=\"ML\">Mali<\/option><option  value=\"Malta\" data-code=\"MT\">Malta<\/option><option  value=\"Marshall Islands\" data-code=\"MH\">Marshall Islands<\/option><option  value=\"Martinique\" data-code=\"MQ\">Martinique<\/option><option  value=\"Mauritania\" data-code=\"MR\">Mauritania<\/option><option  value=\"Mauritius\" data-code=\"MU\">Mauritius<\/option><option  value=\"Mayotte\" data-code=\"YT\">Mayotte<\/option><option  value=\"Mexico\" data-code=\"MX\">Mexico<\/option><option  value=\"Micronesia\" data-code=\"FM\">Micronesia<\/option><option  value=\"Moldova\" data-code=\"MD\">Moldova<\/option><option  value=\"Monaco\" data-code=\"MC\">Monaco<\/option><option  value=\"Mongolia\" data-code=\"MN\">Mongolia<\/option><option  value=\"Montenegro\" data-code=\"ME\">Montenegro<\/option><option  value=\"Montserrat\" data-code=\"MS\">Montserrat<\/option><option  value=\"Morocco\" data-code=\"MA\">Morocco<\/option><option  value=\"Mozambique\" data-code=\"MZ\">Mozambique<\/option><option  value=\"Myanmar\" data-code=\"MM\">Myanmar<\/option><option  value=\"Namibia\" data-code=\"NA\">Namibia<\/option><option  value=\"Nauru\" data-code=\"NR\">Nauru<\/option><option  value=\"Nepal\" data-code=\"NP\">Nepal<\/option><option  value=\"Netherlands\" data-code=\"NL\">Netherlands<\/option><option  value=\"New Caledonia\" data-code=\"NC\">New Caledonia<\/option><option  value=\"New Zealand\" data-code=\"NZ\">New Zealand<\/option><option  value=\"Nicaragua\" data-code=\"NI\">Nicaragua<\/option><option  value=\"Niger\" data-code=\"NE\">Niger<\/option><option  value=\"Nigeria\" data-code=\"NG\">Nigeria<\/option><option  value=\"Niue\" data-code=\"NU\">Niue<\/option><option  value=\"Norfolk Island\" data-code=\"NF\">Norfolk Island<\/option><option  value=\"North Korea\" data-code=\"KP\">North Korea<\/option><option  value=\"Northern Mariana Islands\" data-code=\"MP\">Northern Mariana Islands<\/option><option  value=\"Norway\" data-code=\"NO\">Norway<\/option><option  value=\"Oman\" data-code=\"OM\">Oman<\/option><option  value=\"Pakistan\" data-code=\"PK\">Pakistan<\/option><option  value=\"Palau\" data-code=\"PW\">Palau<\/option><option  value=\"Palestine\">Palestine<\/option><option  value=\"Panama\" data-code=\"PA\">Panama<\/option><option  value=\"Papua New Guinea\" data-code=\"PG\">Papua New Guinea<\/option><option  value=\"Paraguay\" data-code=\"PY\">Paraguay<\/option><option  value=\"Peru\" data-code=\"PE\">Peru<\/option><option  value=\"Philippines\" data-code=\"PH\">Philippines<\/option><option  value=\"Pitcairn\" data-code=\"PN\">Pitcairn<\/option><option  value=\"Poland\" data-code=\"PL\">Poland<\/option><option  value=\"Portugal\" data-code=\"PT\">Portugal<\/option><option  value=\"Puerto Rico\" data-code=\"PR\">Puerto Rico<\/option><option  value=\"Qatar\" data-code=\"QA\">Qatar<\/option><option  value=\"Reunion\" data-code=\"RE\">Reunion<\/option><option  value=\"Romania\" data-code=\"RO\">Romania<\/option><option  value=\"Russia\" data-code=\"RU\">Russia<\/option><option  value=\"Rwanda\" data-code=\"RW\">Rwanda<\/option><option  value=\"Saint Barthelemy\" data-code=\"BL\">Saint Barthelemy<\/option><option  value=\"Saint Helena, Ascension and Tristan da Cunha\">Saint Helena, Ascension and Tristan da Cunha<\/option><option  value=\"Saint Kitts and Nevis\" data-code=\"KN\">Saint Kitts and Nevis<\/option><option  value=\"Saint Lucia\" data-code=\"LC\">Saint Lucia<\/option><option  value=\"Saint Martin (French part)\">Saint Martin (French part)<\/option><option  value=\"Saint Pierre and Miquelon\" data-code=\"PM\">Saint Pierre and Miquelon<\/option><option  value=\"Saint Vincent and the Grenadines\" data-code=\"VC\">Saint Vincent and the Grenadines<\/option><option  value=\"Samoa\" data-code=\"WS\">Samoa<\/option><option  value=\"San Marino\" data-code=\"SM\">San Marino<\/option><option  value=\"Sao Tome and Principe\" data-code=\"ST\">Sao Tome and Principe<\/option><option  value=\"Saudi Arabia\" data-code=\"SA\">Saudi Arabia<\/option><option  value=\"Senegal\" data-code=\"SN\">Senegal<\/option><option  value=\"Serbia\" data-code=\"RS\">Serbia<\/option><option  value=\"Seychelles\" data-code=\"SC\">Seychelles<\/option><option  value=\"Sierra Leone\" data-code=\"SL\">Sierra Leone<\/option><option  value=\"Singapore\" data-code=\"SG\">Singapore<\/option><option  value=\"Sint Maarten (Dutch part)\">Sint Maarten (Dutch part)<\/option><option  value=\"Slovakia\" data-code=\"SK\">Slovakia<\/option><option  value=\"Slovenia\" data-code=\"SI\">Slovenia<\/option><option  value=\"Solomon Islands\" data-code=\"SB\">Solomon Islands<\/option><option  value=\"Somalia\" data-code=\"SO\">Somalia<\/option><option  value=\"South Africa\" data-code=\"ZA\">South Africa<\/option><option  value=\"South Georgia and the South Sandwich Islands\" data-code=\"GS\">South Georgia and the South Sandwich Islands<\/option><option  value=\"South Korea\" data-code=\"KR\">South Korea<\/option><option  value=\"South Sudan\" data-code=\"SS\">South Sudan<\/option><option  value=\"Spain\" data-code=\"ES\">Spain<\/option><option  value=\"Sri Lanka\" data-code=\"LK\">Sri Lanka<\/option><option  value=\"Sudan\" data-code=\"SD\">Sudan<\/option><option  value=\"Suriname\" data-code=\"SR\">Suriname<\/option><option  value=\"Svalbard and Jan Mayen\" data-code=\"SJ\">Svalbard and Jan Mayen<\/option><option  value=\"Swaziland\" data-code=\"SZ\">Swaziland<\/option><option  value=\"Sweden\" data-code=\"SE\">Sweden<\/option><option  value=\"Switzerland\" data-code=\"CH\">Switzerland<\/option><option  value=\"Syria\" data-code=\"SY\">Syria<\/option><option  value=\"Taiwan\" data-code=\"TW\">Taiwan<\/option><option  value=\"Tajikistan\" data-code=\"TJ\">Tajikistan<\/option><option  value=\"Tanzania\" data-code=\"TZ\">Tanzania<\/option><option  value=\"Thailand\" data-code=\"TH\">Thailand<\/option><option  value=\"Timor-Leste\">Timor-Leste<\/option><option  value=\"Togo\" data-code=\"TG\">Togo<\/option><option  value=\"Tokelau\" data-code=\"TK\">Tokelau<\/option><option  value=\"Tonga\" data-code=\"TO\">Tonga<\/option><option  value=\"Trinidad and Tobago\" data-code=\"TT\">Trinidad and Tobago<\/option><option  value=\"Tunisia\" data-code=\"TN\">Tunisia<\/option><option  value=\"Turkey\" data-code=\"TR\">Turkey<\/option><option  value=\"Turkmenistan\" data-code=\"TM\">Turkmenistan<\/option><option  value=\"Turks and Caicos Islands\" data-code=\"TC\">Turks and Caicos Islands<\/option><option  value=\"Tuvalu\" data-code=\"TV\">Tuvalu<\/option><option  value=\"Uganda\" data-code=\"UG\">Uganda<\/option><option  value=\"Ukraine\" data-code=\"UA\">Ukraine<\/option><option  value=\"United Arab Emirates\" data-code=\"AE\">United Arab Emirates<\/option><option  value=\"United Kingdom\" data-code=\"GB\">United Kingdom<\/option><option  value=\"United States\" data-code=\"US\">United States<\/option><option  value=\"United States Minor Outlying Islands\" data-code=\"UM\">United States Minor Outlying Islands<\/option><option  value=\"Uruguay\" data-code=\"UY\">Uruguay<\/option><option  value=\"Uzbekistan\" data-code=\"UZ\">Uzbekistan<\/option><option  value=\"Vanuatu\" data-code=\"VU\">Vanuatu<\/option><option  value=\"Vatican City\">Vatican City<\/option><option  value=\"Venezuela\" data-code=\"VE\">Venezuela<\/option><option  value=\"Vietnam\" data-code=\"VN\">Vietnam<\/option><option  value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option  value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option  value=\"Wallis and Futuna\" data-code=\"WF\">Wallis and Futuna<\/option><option  value=\"Western Sahara\" data-code=\"EH\">Western Sahara<\/option><option  value=\"Yemen\" data-code=\"YE\">Yemen<\/option><option  value=\"Zambia\" data-code=\"ZM\">Zambia<\/option><option  value=\"Zimbabwe\" data-code=\"ZW\">Zimbabwe<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">Country<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n\t\t<input  type=\"hidden\" name=\"item_meta[2401]\" id=\"field_6g4b833\" value=\"\"  data-sectionid=\"2398\"     \/>\n\t\t\t\t<input  type=\"hidden\" name=\"item_meta[2402]\" id=\"field_wcle633\" value=\"\"  data-sectionid=\"2398\"     \/>\n\t\t\t\t<input  type=\"hidden\" name=\"item_meta[2403]\" id=\"field_o9gox33\" value=\"\"  data-sectionid=\"2398\"  data-placeholder=\"Choose an option\"     \/>\n\t\t\t\t<input  type=\"hidden\" name=\"item_meta[2404]\" id=\"field_60922a33\" value=\"\"  data-sectionid=\"2398\"     \/>\n\t\t<div id=\"frm_field_2405_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_k6sca3\" id=\"field_k6sca3_label\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_k6sca3\" name=\"item_meta[2405]\" value=\"\"  data-sectionid=\"2398\"  data-frmmask=\"(000)000-0000\" data-reqmsg=\"Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"\\(\\d\\d\\d\\)\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2528_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_15ix2\" id=\"field_15ix2_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_15ix2\" name=\"item_meta[2528]\" value=\"\"  data-sectionid=\"2398\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3448_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first vertical_radio\">\r\n\t<div  id=\"field_wapah_label\" class=\"frm_primary_label\">Qu\u00e9bec Enterprise Number (NEQ) or Canada Business Number (BN)\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_wapah_label\" role=\"group\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_3448-2398-0\">\t\t\t<label  for=\"field_wapah-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[3448][]\" id=\"field_wapah-0\" value=\"NEQ (Qu\u00e9bec)\"  data-sectionid=\"2398\"  data-frmlimit=\"1\"  data-frmmin=\"1\"  data-reqmsg=\"Qu\u00e9bec Enterprise Number (NEQ) or Canada Business Number (BN) cannot be blank.\" data-invmsg=\"Qu\u00e9bec Enterprise Number (NEQ) or Canada Business Number (BN) is invalid\"   aria-required=\"true\"  \/> NEQ (Qu\u00e9bec)<\/label><\/div>\n\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_3448-2398-1\">\t\t\t<label  for=\"field_wapah-1\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[3448][]\" id=\"field_wapah-1\" value=\"BN (Canada)\"  data-sectionid=\"2398\"  data-frmlimit=\"1\"  data-frmmin=\"1\"  data-reqmsg=\"Qu\u00e9bec Enterprise Number (NEQ) or Canada Business Number (BN) cannot be blank.\" data-invmsg=\"Qu\u00e9bec Enterprise Number (NEQ) or Canada Business Number (BN) is invalid\"   \/> BN (Canada)<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_3449_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n\t<label for=\"field_anka0\" id=\"field_anka0_label\" class=\"frm_primary_label\">NEQ number (Qu\u00e9bec)\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input  type=\"text\" id=\"field_anka0\" name=\"item_meta[3449]\" value=\"\"  data-sectionid=\"2398\"  data-reqmsg=\"NEQ number (Qu\u00e9bec) cannot be blank.\" aria-required=\"true\" data-invmsg=\"NEQ number (Qu\u00e9bec) is invalid\" aria-invalid=\"false\"   \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_3450_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n\t<label for=\"field_s81o9\" id=\"field_s81o9_label\" class=\"frm_primary_label\">NB number (Canada)\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input  type=\"text\" id=\"field_s81o9\" name=\"item_meta[3450]\" value=\"\"  data-sectionid=\"2398\"  data-reqmsg=\"NB number (Canada) cannot be blank.\" aria-required=\"true\" data-invmsg=\"NB number (Canada) is invalid\" aria-invalid=\"false\"   \/>\r\n\t\r\n\t\r\n<\/div>\n<\/div>\n<div id=\"frm_field_2529_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">APPLICANT INFORMATION<\/h3>\r\n\r\n\r\n<div id=\"frm_field_2531_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <div  id=\"field_4419g_label\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <fieldset aria-labelledby=\"field_4419g_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tName\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_2531\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_2531-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_4419g_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_4419g_first\" value=\"\" name=\"item_meta[2531][first]\" autocomplete=\"given-name\" data-sectionid=\"2529\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_2531_first_desc\">First<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_2531-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_4419g_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_4419g_last\" value=\"\" name=\"item_meta[2531][last]\" autocomplete=\"family-name\" data-sectionid=\"2529\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_2531_last_desc\">Last<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2532_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_c511q\" id=\"field_c511q_label\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_c511q\" name=\"item_meta[2532]\" value=\"\"  data-sectionid=\"2529\"  data-frmmask=\"(000)000-0000\" data-reqmsg=\"Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"\\(\\d\\d\\d\\)\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2533_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_7wp8\" id=\"field_7wp8_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_7wp8\" name=\"item_meta[2533]\" value=\"\"  data-sectionid=\"2529\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_2500_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">BANK REFERENCES<\/h3>\r\n\r\n\r\n<div id=\"frm_field_2501_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_54g6d32\" id=\"field_54g6d32_label\" class=\"frm_primary_label\">Name of the bank\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_54g6d32\" name=\"item_meta[2501]\" value=\"\"  data-sectionid=\"2500\"  data-reqmsg=\"Name of the bank cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2502_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_qaukz32\" id=\"field_qaukz32_label\" class=\"frm_primary_label\">Address\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_qaukz32\" name=\"item_meta[2502]\" value=\"\"  data-sectionid=\"2500\"  data-reqmsg=\"Address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2503_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_w5mc92\" id=\"field_w5mc92_label\" class=\"frm_primary_label\">Phone\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_w5mc92\" name=\"item_meta[2503]\" value=\"\"  data-sectionid=\"2500\"  data-frmmask=\"(000)000-0000\" data-reqmsg=\"Phone cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"\\(\\d\\d\\d\\)\\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2504_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_1qcl32\" id=\"field_1qcl32_label\" class=\"frm_primary_label\">Contact person\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_1qcl32\" name=\"item_meta[2504]\" value=\"\"  data-sectionid=\"2500\"  data-reqmsg=\"Contact person cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_2506_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\r\n<h3 class=\"frm_pos_top\">SUPPLIERS\u2019 REFERENCES<\/h3>\r\n<div id=\"frm_desc_field_hxkdw32\" class=\"frm_description frm_section_spacing\">3 references requested<\/div>\r\n\r\n<div id=\"frm_field_2507_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_htnpv32\" id=\"field_htnpv32_label\" class=\"frm_primary_label\">Company\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_htnpv32\" name=\"item_meta[2507]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Company cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2508_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_8hzus32\" id=\"field_8hzus32_label\" class=\"frm_primary_label\">Contact\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_8hzus32\" name=\"item_meta[2508]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Contact cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3419_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n\t<label for=\"field_jvmpv\" id=\"field_jvmpv_label\" class=\"frm_primary_label\">Email\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input type=\"email\" id=\"field_jvmpv\" name=\"item_meta[3419]\" value=\"\"  data-sectionid=\"2506\"  autocomplete=\"email\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_2510_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_hu35t32\" id=\"field_hu35t32_label\" class=\"frm_primary_label\">Company\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_hu35t32\" name=\"item_meta[2510]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Company cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2511_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_q8xo332\" id=\"field_q8xo332_label\" class=\"frm_primary_label\">Contact\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_q8xo332\" name=\"item_meta[2511]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Contact cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3420_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n\t<label for=\"field_er8fy\" id=\"field_er8fy_label\" class=\"frm_primary_label\">Email\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input type=\"email\" id=\"field_er8fy\" name=\"item_meta[3420]\" value=\"\"  data-sectionid=\"2506\"  autocomplete=\"email\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_2513_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_x7vnp32\" id=\"field_x7vnp32_label\" class=\"frm_primary_label\">Company\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_x7vnp32\" name=\"item_meta[2513]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Company cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2514_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_zs9rx32\" id=\"field_zs9rx32_label\" class=\"frm_primary_label\">Contact\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_zs9rx32\" name=\"item_meta[2514]\" value=\"\"  data-sectionid=\"2506\"  data-reqmsg=\"Contact cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3421_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n\t<label for=\"field_97l7a\" id=\"field_97l7a_label\" class=\"frm_primary_label\">Email\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input type=\"email\" id=\"field_97l7a\" name=\"item_meta[3421]\" value=\"\"  data-sectionid=\"2506\"  autocomplete=\"email\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n\t\r\n\t\r\n<\/div>\n<\/div>\n<div id=\"frm_field_2517_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">OVERDUE ACCOUNTS<\/h3>\r\n\r\n\r\n<div id=\"frm_field_2518_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>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.<\/p>\n<p>By signing this form, I authorize BioFloral to obtain or exchange information with any information agent or credit company for reference and credit checks.<\/p>\n<\/div>\n<div id=\"frm_field_2519_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_2pfmo32\" id=\"field_2pfmo32_label\" class=\"frm_primary_label\">Electronic signature\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_2pfmo32\" name=\"item_meta[2519]\" value=\"\"  data-sectionid=\"2517\"  placeholder=\"Enter your name here\" data-reqmsg=\"Electronic signature cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_2pfmo32\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_2pfmo32\">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.<\/div>\r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_2521_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">PERSONAL GUARANTEE<\/h3>\r\n\r\n\r\n<div id=\"frm_field_2522_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>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, \u00a0I expressly waive the benefits of division and discussion.<\/p>\n<\/div>\n<div id=\"frm_field_2523_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\r\n    <label for=\"field_f1n7v32\" id=\"field_f1n7v32_label\" class=\"frm_primary_label\">Guarantor's name\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_f1n7v32\" name=\"item_meta[2523]\" value=\"\"  data-sectionid=\"2521\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_2524_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\r\n    <label for=\"field_8zxny32\" id=\"field_8zxny32_label\" class=\"frm_primary_label\">Guarantor's home address\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_8zxny32\" name=\"item_meta[2524]\" value=\"\"  data-sectionid=\"2521\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_3414_container\" class=\"frm_form_field  frm_html_container form-field\">By signing at the bottom of this form:<br \/>\nYou acknowledge and confirm that you have the authority to sign for and on behalf of the company for which you are applying.<br \/>\nYou consent to BioFloral conducting a proper credit investigation.\n<\/div>\n<div id=\"frm_field_2525_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_jwf632\" id=\"field_jwf632_label\" class=\"frm_primary_label\">Electronic signature\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_jwf632\" name=\"item_meta[2525]\" value=\"\"  data-sectionid=\"2521\"  placeholder=\"Enter your name here\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_jwf632\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_jwf632\">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.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_2526_container\" class=\"frm_form_field  frm12 frm_first frm_html_container form-field\">\n<p>By refusing to complete and sign this section, you agree that no line of credit will be granted to you.<\/p>\n<\/div>\n<\/div>\n<div id=\"frm_field_3412_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Send<\/button>\r\n\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_3461_container\">\n\t\t\t<label for=\"field_390cb\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_390cb\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[3461]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"hDMV\/vp9SrFughdg1rEqW5\/LvLwlMpsuUQOYYDhyT4zB9fPEtK9yhLoGuoS42RJj\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-1584","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/pages\/1584","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/comments?post=1584"}],"version-history":[{"count":8,"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/pages\/1584\/revisions"}],"predecessor-version":[{"id":3964,"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/pages\/1584\/revisions\/3964"}],"wp:attachment":[{"href":"https:\/\/biofloral.ca\/en\/wp-json\/wp\/v2\/media?parent=1584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}