CLIENT INTAKE FORM

Client info
This is the person responsible for approving the site location agreement.
This is the person responsible for implementing Jevo day-to-day.
The cost of Jevo is $4,995 plus $350 for Shipping & Handling. The customer is responsible for providing the water line to Jevo, waste drain access and a 15 AMP dedicated circuit may be required.
Financing application info
Complete all fields in this section to apply for financing. Final payment will be provided by the financing company as taxes may apply. Please note, financing approval requires a minimum credit score of 620. Cash, ACH draft or credit card are acceptable forms of payment if financing is not approved.
How many of the requested Jevos will you finance?
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Financing Disclosure (for Applicants Only)
By checking this box you agree that each undersigned individual(s), who is either a principle of the credit applicant listed above or a personal guarantor of its obligations, is providing authorization to Food & Beverage Innovations LLC. or its designee authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the creditapplicant and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account. A photocopy, email or facsimile copy of this authorization shall be as valid as the original. In addition, the undersigned authorizes financial institutions and creditors the right to release by telephone or fax all credit information requested.
Primary billing info
Primary installation location
Flavor Pod Shipping location info if different than above