Order Form:

Please understand it will be necessary for a sales representative to contact you back so
please leave valid information. Please also understand that due to market conditions
certain brands and or items are not guaranteed by A&J Produce. Once your order is
received and processed a email will be sent back to you stating what we have and do not
have. Thank you for being a customer at A&J Produce.

ALSO PLEASE NOTE: You may have to fill out multiple forms if your order exceeds more than four items.

Name:
Company:
Address:
Phone:
Email:

Have you ordered with A&J Produce before? Yes No.

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Item #1
Fruit/Vegetable:
Brand:
Origin:
Quantity:
Weight:
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Item #2
Fruit/Vegetable:
Brand:
Origin:
Quantity:
Weight:
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Item #3
Fruit/Vegetable:
Brand:
Origin:
Quantity:
Weight:
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Item #4
Fruit/Vegetable:
Brand:
Origin:
Quantity:
Weight:

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Please scroll to read the U.S. Persishables Act before placing order.

United States law of Perishables Act

The perishable agricultural commodities listed on this invoice are sold subject to the statutory trust authorized by Section 5(c) of the Perishable Agricultural Commodities Act 1920 (7 U.S.C. 499(e) (c)). The seller of these commodities retains a trust claim over these commodities, all inventories of food or other products derived from these commodities, and any receivable or proceeds from the sale of these commodities until full payment is received. In the event of the enforcement of our trust claim, we seek to recover reasonable attorney’s fees and the costs of recover.

Order Form:

Item #1

Item #2

Item #3

Item #4