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Section 1 - Contact Information:
Section 2 - Billing Information:
We are required by the State of Florida to collect sales tax for shipments delivered within the state, unless we have a valid resale certificate number on file.
If your business is in State of Florida and you do not wish to be charged sales tax, please enter your Florida Resale Certificate Information.
(Note: Sales tax will be charged on all orders until we receive copy by fax of your Resale Certificate and we are unable to retroactively credit back the sales tax. Please fax asap to 305.293.0920.)
Names and Titles of those who are authorized to make purchase for your company.
Electronic signature: By checking below and typing my name, I agree that I am authorized to complete this application for the company, am a valid retailer and that the above persons are authorized by me to make purchases on behalf of our company. I hold Island Image harmless for any abuse of our purchasing powers or errors by our employees. If I have checked above that I will be using credit card, by checking below and typing my name, I agree to pay all subsequent credit card charges incurred by myself or my employees at my authorization, according to card issuer agreement.