NurseryIndustry

UNIFORMCONFIDENTIAL CREDIT APPLICATION & PURCHASE ORDER AGREEMENT

(Forthe wholesale trade; NOT for consumer or retail use)

We welcome your interest indoing business with our company!

For your convenience and toserve you more speedily and completely, we encourage establishment of an openaccount.  All information

submitted will be held instrictest confidence and used solely to determine your line of credit.  It is not mandatory that all items becompleted; however, the greater your participation the quicker your applicationcan be acted upon (allow a minimum of two weeks for processing).

FIRMNAME:_________________________________________________________

TELEPHONE: (         )_______________________________

Name of Parent Company ifSubsidiary:_____________________________________________________________________________

ADDRESS______________________________________

CITY__________________________STATE__________________ZIP_____________

LEGAL STATUS:
( X )__________PROPRIETORSHIP__________PARTNERSHIP__________INCORP. In(STATE):__________19________

YEARESTABLISHED:____________   AT PRESENTLOCATIONS SINCE:___________   OWNED:___________
LEASED FROM:___________

NATURE OF BUSINESS: (i.e.,Retail, Landscape, etc.)________________________________________

       OFFECERS/OWNERS NAMES:                                        TITLES:    AGES:               RESIDENCES:                                           TELEPHONE:

___________________________________________          _______  _______  _________________________              (     )________________________

___________________________________________          _______  _______  _________________________              (     )________________________

___________________________________________          _______  _______  _________________________              (     )________________________

___________________________________________          _______  _______  _________________________              (     )________________________

(PlaceX beside person responsible for accounts payable)

TRADE REFERENCES: (Indicatefirms from whom you are currently purchasing an open account)

                  NAME:                                           ADDRESS:                                                                 CITY:                           STATE:      ZIP:           TELEPHONE:

_________________________              __________________________________            ________________                _______  _______  ()___________

_________________________              __________________________________            ________________                _______  _______  ()___________

_________________________              __________________________________            ________________                _______  _______  ()___________

_________________________              __________________________________            ________________                _______  _______  ()___________

BANK REFERENCES: NAME &BRANCH:_______________________________________________________   Phone (    )_______________

Address:_______________________________________Officer/Dept.___________________________________   Ck Account#______________

LoanAccount:_____________________ Savings Account#_____________________With:____________________________________________

AMOUNT OF CREDIT DESIRED:$__________________________

(Note: For amounts greater than $_____________________________ fill in theattached sheet of supplemental information.)

TERMS: Applicant is herebyadvised that our regularly stated terms are: 30 days NET.  Past due accounts will be assessed a servicecharge of

1 ˝% per month or at a ratenot to exceed lawful limits.  All claimsfor errors or unsatisfactory stock must be reported upon receipt and confirmedby written memorandum within 10 days lest all consideration be waived.

ADDITIONAL PROVISIONS OF OUR COMPANY INCLUDE:

In the event it becomesnecessary for our firm to file suit to enforce payment, we shall be entitled tocourt costs, attorney’s fees and interest at the rate of 1 ˝% per month on allamounts due and payable.

CORPORATION OFFICERSHEREWITH ACKNOWLEDGE AND ASSUME PERSONAL RESPONSIBILITY FOR DEBTS INCURRED INTHE NAME OF THE FIRM:

Individual:_____________________________________________     Individual:______________________________________________

                Signature                  Title                        Date                                         Signature                  Title                        Date

Individual:_____________________________________________     Individual:______________________________________________

                Signature                  Title                        Date                                         Signature                  Title                        Date

I HAVE READ, UNDERSTAND ANDACCEPT THE ABOVE TERMS, HAVE PROVIDED TRUE INFORMATION TO THE BEST OF MYKNOWLEDGE AND HAVE RETAINED A COPY OF THIS AGREEMENT FOR MY RECORDS.  I FURTHER AUTHORIZE THE ABOVE CITEDREFERENCES TO SUPPLY PERTINENT INFORMATION AS MAY BE REQUIRED TO DETERMINE OURCREDIT CAPABILITIES.

Applicant:__________________________________________________________________   ____________________   ____________________

                                            (Signature & Title of ResponsibleOfficer)                                                  (Soc. Security #)                           (Date)

(Applicant does notwrite in this space)

PREVIOUS EXPERIENCEWITH APPLICANTAPPLICANT:______________________________________DISPOSITION:___________________________

REASON:_____________________________________________CR. LIMIT:______________ DATE:______________ BY:________________