Form Test Page Order - Logged out - Live form Step 1 of 3 33% Delivery and Other InformationIs this a new order or an add-on to an existing order?New orderAdd-on to existing orderFor add-on, please enter the Octoraro order number this should be added to. Delivery:Pick UpONPN DeliveryPreferred Pickup/Ship Date:* MM slash DD slash YYYY Pickup/Ship No Later Than:* MM slash DD slash YYYY Terms and Conditions for Pick Ups and Deliveries*Pick ups: Orders only available for pickup Tuesday through Friday. Must pick up order in the week requested or additional holding charges may apply. Deliveries: Customer must meet driver and provide appropriate labor to assist with unloading. A person with responsibility for signing off on receipt of plants must be present onsite. Agree Directions to Delivery Site:Mobile phone at delivery site:PA Tax Exemption Number (For Pick Ups / Deliveries in PA ): Please Upload Copy of PA Tax Exemption Certificate:Accepted file types: pdf, png, jpg, Max. file size: 32 MB.Job Name: Purchase Order Number: Billing and Shipping information.Billing InformationCompany / Organization Name:* First Name* Last Name:* Address:* Address Line 2: City:* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip:* Billing Email:* Phone:*Fax:Mobile phone (if different from mobile number at delivery site) )Shipping InformationCopy Shipping Details from Billing Details . Company Name:* First Name:* Last name:* Address:* Address Line 2: City:* State:*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip:* Email:* Delivery Site Phone:* Type of Payment:*Company CheckCredit Card Please call 717-529-3160 with your credit card details. Total $0.00 plants ordered for a total of Price: Order details:Comments:EmailThis field is for validation purposes and should be left unchanged. Δ
