City, State & Zip:
Years in Business:
Nursery Dealers License:
Federal ID Number:
Indiana Retail Merchants Certificate Number:
PO REQUIRED?JOB NAME REQUIRED?Legal Status:
Type of Business (Check All that Apply):
Name: Position: Cell Phone:
(company's main contact person)
Trade References (business relationships): Please provide names of
or individuals who can substantiate that your business
is a retail garden center or landscape company that
does installation of plant material, i.e. commercial
customers, other suppliers, equipment vendors, etc.
No credit information will be asked.