New Customer Account & Credit Application

Welcome to GP Reeves! Thank you for choosing us for your dispensing automation needs.

To establish your customer account and request credit terms, please complete the application below. Please upload any required documentation as part of your application. Providing complete and accurate information will help us process your application as quickly as possible. Once your application has been submitted, our team will review the information and contact you if any additional details are needed.

Questions? We’re here to help. Contact our Customer Service team at customerservice@gpreeves.com.

"*" indicates required fields

Comments

This field is for validation purposes and should be left unchanged.

Welcome to GP Reeves!

Thank you for choosing us for your dispensing automation needs.

To establish your customer account and request credit terms, please complete the application below. Fields marked with an * are required.

Please upload any required documentation as part of your application. Providing complete and accurate information will help us process your application as quickly as possible.

Once your application has been submitted, our team will review the information and contact you if any additional details are needed.

Questions? We're here to help. Contact our Customer Service team at customerservice@gpreeves.com.

Contact Information

Who should we contact regarding this application?

Contact Name*

Job Title

Phone Number*

Email Address*

Company Contacts & Accounts Payable

Primary Business Contact*

Job Title

Phone Number*

Email Address*

Accounts Payable Contact*

Invoices will be sent to the AP email listed below.

Phone Number*

Email Address*

Shipping Information

Is the shipping address different than the business/billing address?*

Yes

Shipping Address*

Preferred Parcel Carrier*

Parcel Account #

Preferred Freight Carrier*

Freight Account #

Shipping Terms

Customs Broker Information

Broker Company*

Contact Name*

Broker Address*

Phone Number*

Email Address

Credit References

Please provide your primary banking relationship.

Bank Reference*

Contact Name

City

State / Province

Phone Number*

Email Address

Trade References

Reference Type*

Provide trade references by uploading your own file, or by manual entry (Choose One).

Upload Trade References File (.pdf, .jpg., .png)

Input Trade References Manually

File Upload*

Upload a document containing at least three trade references.

Accepted file types: pdf, jpg, png, Max. file size: 10 MB.

TRADE REFERENCE 1

Company Name*

Contact Name*

Phone Number*

Email Address

TRADE REFERENCE 2

Company Name*

Contact Name*

Phone Number*

Email Address

TRADE REFERENCE 3

Company Name*

Contact Name*

Phone Number*

Email Address

Additional Information

Company Relationship

Tax Exempt*

Is your organization tax exempt?

Yes

If Yes, Upload Tax Exempt Certificate

Accepted file types: pdf, jp, png, Max. file size: 2 GB.

Additional Comments / Special Instructions:

Review & Submit

By signing below, I certify that:

The information provided is complete and accurate to the best of my knowledge.
I am authorized to submit this application on behalf of my organization.
GP Reeves may request additional information or documentation to process this application.
There is an additional 3% fee for credit card orders.
If my organization is tax exempt, I will provide a valid Tax-Exempt Certificate before an order is processed.

Application Certification*

I certify that I have read, understood, and agree to the terms listed above.

Date*

Electronic Signature*

By typing your name above, you acknowledge and agree that this electronic signature is legally binding, just as if you had signed a paper document.

Doing Business With GP Reeeves

When placing an order with GP Reeves, we will require an official purchase order with the information listed below. Please include ALL required information in order to ensure your order is processed in a timely manner.

Purchase orders should be emailed to customerservice@gpreeves.com

Bill To Address

gftr

Ship To Address

lop

Contact Information

Purchase Order #

fgt

Shipping Conditions

gyh

Payment Terms

Standard (Net 30)

Request Date

huj

Item description and part numbers

juh

Quantity

jui

Quotes/Agreed Price

Quotes are valid for 30 days.

Making a Payment

We accept the following payment methods:

Bank/Wire Transfer

GP Reeves banking information will be provided once your order is received.

Credit Card

Please call 1-800-399-8893 to place your card on file.

We Accept:

VISA, MASTERCARD, DISCOVER, AMEX
There is an additional 3% fee for credit card orders.

Check

Mail Checks To:

4551 Holland Ave
Holland, MI 49424

New Customer Account & Credit Application

Contact Information

Company Information

Company Contacts & Accounts Payable

Shipping Information

Customs Broker Information

Credit References

Trade References

Additional Information

Review & Submit

Doing Business With GP Reeeves

Bill To Address

Ship To Address

Contact Information

Purchase Order #

Shipping Conditions

Payment Terms

Request Date

Item description and part numbers

Quantity

Quotes/Agreed Price

Making a Payment

Bank/Wire Transfer

Credit Card

Check

Contact Us

customerservice@gpreeves.com

(616) 399-8893

4551 Holland Ave, Holland, MI 49424

Service

servicesupport@gpreeves.com

(616) 266-9229

ISO 9001:2015 CERTIFIED QMS

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