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Menu
Home
About
Why Choose Borrelli
Personal
Auto Insurance
Flood Insurance
Home Insurance
Life & Health Insurance
Personal Liability
Renters Insurance
Umbrella Insurance
Watercraft & Boat
Commercial
About Commercial
Commercial Property
Commercial Auto Insurance
Contractors Insurance
Cyber Liability Insurance
General Liability
Health Insurance
Restaurant Insurance
Surety Bond
Commercial Umbrella Insurance
Workers Compensation
Carriers
Report A Claim
Contact
CONSULTATION REQUEST FORM
1. CONTACT INFORMATION
Business Name:
Owner / Contact Name:
Email
Phone:
2. BUSINESS PROFILE
Business Type (select all that apply):
Retail
Wholesale
B2B
Restaurant
Service
Contractor/Trades
E-Commerce
Monthly Processing Volume:
Under $25,000
$25,000 - $100,000
$100,000 - $500,000
$500,000 - $1,000,000
$1,000,000+
3. POINT OF SALE + HOW YOU CHARGE CUSTOMERS
POS Setup:
POS System
Describe Your POS (Clover, Square, Toast, Micros, etc.):
Standalone Terminals:
Standalone Terminals (Ingenico, Verifone, PAX, Wireless Terminals, Countertop Devices)
Primary Payment Methods:
In-person
Deliveries
Phone Orders (MOTO)
Online/Website
Invoicing
4. PAIN POINTS
High Processing Fees
Reconciliation/Accounting Issues
Chargebacks/Fraud
Slow Deposits
Need ACH + Credit Card Options
Equipment/Terminals Not Reliable
Other
*Paint Points - if Other, please describe:
5. DOCUMENT UPLOAD
Upload recent processing statements or screenshots
Accepted: PDF, CSV, JPG, PNG, XLSX
6. NEXT STEPS
A GPA Specialist will review your information and reply within 24 hours.
*Provide Preferred Email Address below:
SUBMIT FORM
