GR3367
Guarantor form arial
5/26/06
3:12 PM
Page 1
Guarantor Form
(PLEASE CHECK ONE)
u New Application
u Change of Ownership (Teleflora Shop Code #) _____________
u Branch Shop Application (Parent Shop Code #) ______________
PART A – Shop Information
(Please use blue or black ink. Type or print legibly.)
Shop Name (DBA in full) _________________________________ Business Phone # (
Legal Business Name (if different) _____________________________ ) ________________ Fax # ( ) _______________________
) ________________ Toll-Free Phone # (
Physical Shop Address ________________________________________________________________________________________________ City _________________________________________ County ________________________ State _________ Zip ___________________
PART B – Guarantor Information
u Mr. Full Legal Name Title Social Security Number Residence Phone Number Spouse’s Full Name Present Home Address City, State, Zip Previous Home Address
(If at present address less than 5 years)
(Must be filled out completely to process application.)
NAMES OF GUARANTORS: (If more than two persons, please attach a separate sheet.) u Mrs. u Ms. u Mr. u Mrs. u Ms. 1. __________________________________________ __________________________________________ __________________________________________ ( ) __________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ ) __________________________________ _________________________________________ __________________________________________ ________ / ________ through ________ / _______ __________________________________________ 2. __________________________________________ __________________________________________ __________________________________________ ( ) __________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ ( ) __________________________________ _________________________________________ __________________________________________ ________ / ________ through ________ / _______ __________________________________________
City, State, Zip Present Employer Present Employer’s Address City, State, Zip Years Employed Position/Title
Present Employer’s Phone # (
GUARANTOR’S PERSONAL REFERENCE: (Relat ive preferred; p resent owner not acceptable.) Name ____________________________ Relationship _______________________ Phone # ( ) _________________________ Zip ________________ Street Address ___________________________________ City _________________________ State ______
Any notice regarding changes to this agreement must be provided at least 90 days in advance of the effective date of such notice.
PART C – Guarantor Agreement
Each of the undersigned guarantors (each, a “Guarantor”), by its signature below, jointly and severally, guarantees, unconditionally, the full and faithful performance by the shop described in Part A of this Guarantor Form (the “Shop”) of its obligations to Teleflora LLC (“Teleflora”) under its Contract for Membership (the “Agreement”), a form of which Agreement is set forth on the reverse side of this Guarantor Form, and any Other Teleflora Agreement (as defined in the Agreement). Each Guarantor hereby waives and agrees not to assert or take advantage of (i) any right to require Teleflora to proceed against the Shop or any other person or to proceed against or exhaust any security held by Teleflora or to pursue any other remedy before proceeding against such Guarantor; (ii) the defense of the statute of limitations; (iii) demand, protest, notice of dishonor and notices of any other kind; and (iv) any defense based on the election of remedies by Teleflora. Teleflora and the Shop, subject to the terms of the Agreement, may modify the payment or other terms thereof, in each case, without releasing any Guarantor from its liability hereunder. No exercise or non-exercise by Teleflora of any right under the Agreement, no dealing by Teleflora with the Shop or any Guarantor, and no change, impairment or suspension of any right or remedy of Teleflora, shall in any way affect the obligations of Guarantor hereunder or give any such Guarantor recourse against Teleflora. Each Guarantor acknowledges and agrees that it shall be responsible for keeping itself informed of the financial condition of the Shop and of all other circumstances bearing upon the risk of nonperformance by the Shop of the obligations guaranteed hereby, which diligent inquiry would reveal, and agrees that Teleflora shall have no duty to provide information to any such Guarantor. The bankruptcy or insolvency of the Shop shall not release any Guarantor of its obligations hereunder. Each Guarantor acknowledges and agrees that it has read and understands the terms and conditions of the Agreement. Each Guarantor hereby further grants to Teleflora the authority to obtain credit reports and exchange information as described in Section 15 of the Agreement.
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Print Guarantor Name and Title
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Signature
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Date
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Print Guarantor Name and Title
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Signature
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Date
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Print Guarantor Name and Title
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Signature
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Date GR3367 05/06