ACCOUNT SET UP

Is your business on Oahu

Yes (Please proceed with the application)No (If No, you are not eligible to set up a business account as our in-house delivery network is on Oahu. Please continue to order online to ship directly to you or reach out to our distributor partners. Please do not proceed with filling out the form)

Island Maid / Harders Hawaii only delivers to verified commercial addresses on OAHU only. Residential addresses are not eligible for delivery other than through USPS / FedEx / UPS (shipping charges apply) Will-call at warehouse is also available.*

Yes, I understand

Commercial accounts looking to order portion cup juices, water, and sparkling water in bulk will be directed to order from our distributor partners Y. Hata, Sysco, and Hansen.*

Yes, I understand

If you are ordering more than 10 cases (40 gallons) of syrup for delivery, you must have a forklift or a dock at your location.*

Yes, I understand

Island Maid / Harders Hawaii requires a $300 order minimum for delivery. Orders under the minimum will need to be picked up at the warehouse.*

Yes, I understand

Price breaks on Harders Products are available for pallet size orders (144 gallons or more)*

Yes, I understand

What is your intended order frequency. This will determine business account eligibility.

Today's Date*

Date

Your Business Name*

Your Name*

First NameLast Name

Your position in your company*

Phone Number (email is our preferred way to communicate. Phone numbers are for delivery purposes only)*

Please enter a valid phone number.

Fax Number*

Please enter a valid phone number.

Email (Please make sure your email is correct, or we will not be able to set up your account & contact you)*

example@example.com

AP Contact Name*

First NameLast Name

AP Phone Number*

Please enter a valid phone number.

AP Email*

example@example.com

Delivery Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

This is a Commercial Address*

YesNo, I will pick up at warehouse. Please consider ordering online in this case for faster service.

Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Delivery Hours & Instructions*

Please provide detailed instructions for delivery

I agree to be available between 8am and 1:30pm to accept deliveries on my allocated delivery day. Any delivery cancellations or modifications at the time of delivery will be charged a minimum order change fee of $50*

Yes

I agree to submit orders by email by 2pm the day before, or earlier, of my assigned delivery day(s)*

Yes

Payment Terms*

COD (Cash or Check on delivery)Payment Terms- Fill out the Credit Application below

Cash or check upon delivery. Credit card payments are accepted with no fee for pick up orders. A 3% surcharge will be charged for any credit card payments for deliveries. Prior notice is required.*

Yes, I understand

Deliveries will be taken back if payment is not provided upon delivery (unless customer has terms)*

Yes, I understand

Federal Tax ID

Monthly Credit Requested

GE License #

Type Of Business

CorporationPartnershipSole OwnershipLLC

Principals / Owners

	Name	Title	City / State	Phone#
Principals / Owners
Principals / Owners
Principals / Owners

Bank References

	Bank Name	Contact officer	Phone #	Checking Account##
Bank References
Bank References
Bank References

Trade References

	Name	Address	Phone #	Contact
Trade References
Trade References
Trade References

NOTE

Delivery Terms and Conditions Recap

Island Maid / Harders Hawaii only delivers to verified commercial addresses. Residential addresses are not eligible for delivery other than through USPS / FedEx / UPS (shipping charges apply) Will-call at warehouse is also available.
Island Maid / Harders Hawaii requires a $300 order minimum for delivery. Orders under the minimum will need to be picked up at the warehouse.
Customers must be available between 8am and 1:30pm to accept deliveries with payment (unless they have payment terms) on their allocated delivery day.
Any delivery cancellations or modifications at the time of delivery will be charged a minimum order change fee of $50.
Orders must be emailed by 2pm the day before, or earlier, of the customer's assigned delivery day(s)
Cash or check upon delivery. Credit card payments are accepted with no fee for pick up orders. A 3% surcharge will be charged for any credit card payments for deliveries. Prior notice is required.
Deliveries will be taken back if payment is not provided upon delivery (unless customer has terms)

AREA	DELIVERY DAY(S)
WAIPAHU	MON, TUES, WED, THURS
WAIANAE, NANAKULI, MAKAHA	MONDAYS
KOOLINA, EWA BEACH, KAPOLEI	MONDAYS
MOANALUA, KALIHI, DOWN TOWN, ALA MOANA, WAIKIKI, KAPAHULU	TUESDAYS
WAIPIO, AIEA, PEARL CITY, MILILANI, WAHIAWA, HALEIWA, NORTH SHORE	WEDNESDAYS
WAIALAE, KAIMUKI, AINA HAINA, KOKOMARINA, WAIMANALO, KAILUA, KANEOHE	THURSDAYS

Areas listed above are general guidelines. Inquire about your specific location if your location falls in between the listed areas or is not specifically listed. We are not able to deliver areas between Waimea Valley and He'eia State Park.

By signing here you agree to the above terms and conditions

OAHU BUSINESS ACCOUNT SET-UP

Accounts Payable Contact Information

Credit Application