	PO#
	DATE
	TO
	E-MAIL
	PHONE#
	FROM
	DELIVERY DATE

THIS AUTHORIZES JAMALI FLORAL & GARDEN SUPPLIES TO CHARGE MY CREDIT CARD.
STORE PURCHASE ORDER / CREDIT CARD AUTHORIZATION

CREDIT CARD BILLING INFO:

NAME ON CARD	CONTACT

CREDIT CARD BILLING ADDRESS	BUSINESS NAME

CITY / STATE /ZIP	ADDRESS 1

CREDIT CARD #	ADDRESS 2

EXP. DATE SECURITY CODE	CITY / STATE /ZIP
	I WILL PICK UP MESSENGER MY MESSENGER WILL PICK UP
EMAIL	I WILL PICK UP FROM WAREHOUSE @2201 74^TH ST., NORTH BERGEN, NJ 07047

QTY.	ITEM# / DESCRIPTION PRICE	PRICE	AMOUNT

● DELIVERY ORDERS BELOW $50. WILL INCUR A $10. HANDLING CHARGE PLUS SHIPPING CHARGES. ● MESSENGER DELIVERY/SHIPPING CHARGES WILL BE ADDED AFTER THE ORDER IS FILLED. ● EXCHANGE OR STORE CREDIT ONLY, WITHIN 7 DAYS OF RECEIVING ORDER. ● MUST CALL FOR RETURN AUTHORIZATION NUMBER. ● ALL RETURNS FOR CREDIT AND EXCHANGES ARE SUBJECT TO A 15% RESTOCKING FEE. ● SHIPPING CHARGES ARE NOT REFUNDABLE.	SUBTOTAL
	TAX
	SHIPPING
	TOTAL $


CUSTOMER SIGNATURE	PICK UP NAME / SIGNATURE