New Customers - bluemoonwater

Ready to set up delivery to your home or business? Fill out this form to get on the schedule.

New Customer Intake Form

Account Name *

Contact Name *

Email *

Phone *

Address (of delivery) *

Address (of delivery)

City

State/Province

Zip/Postal

Is your billing address the same as your delivery address?

Yes

Billing Address

City

State/Province

Zip/Postal

Delivery Details

Requesting Services

5 Gallon Refillable Jugs of Spring Water (approx. 42lbs)

3 Gallon Refillable Jugs of Spring Water (approx. 25lbs)

Recyclable Plastic Water Bottles (various sizes, sold by the case)

Vending and Special Events

Sponsorships/Partnerships

Custom Branded Water Bottle Labels

How many Jugs? (Minimum 4 to start)

Will you need a dispenser, such as a Cooler or Crock?

Yes, show me options

No, I have one already

Which type(s) of dispensers might you be interested in?

Crock/Stand

Cooler

Accessories

Rechargeable Electric Pump (as pictured) $25

Rent Bottle Buddy Storage Racks ($1 per shelf per month)

Purchase Bottle Buddy Storage Racks ($15 per shelf)

Compostable Cups ($7.95 qty. 100)

Would you like to purchase or rent a crock/stand?

Purchase Crock and Floor Stand as a pair ($80)

Purchase Crock and Counter Stand as a pair ($70)

Purchase Crock Only ($45)

What kind of Cooler? (Monthly Rentals Only)

Premium Hot & Cold ($16/month)

Hot & Cold ($13.50/month)

Cold & Room Temp. ($11/month)

I need more information

What Kind(s) of Cases?

12 oz. Bottles (24 count)

16.9oz. (or 0.5L) bottles (24 count)

20oz. bottles (24 count)

1.0L bottles (12 count)

How many of these cases in a delivery?

Any questions or comments for our staff?

How did you hear about us?

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Please Note- New service requests may be delayed due to current high demand for service.

Price List

All jugs and bottles are BPA-Free and 100% Recyclable

Delivery Fee - $5

Free Dock Pickups- Mon-Fri 10:00am to 2:00pm

*Certain deliveries will require a higher fee due to high volume, mileage, ease of access, or off schedule/rush deliveries.

5-Gallon Jug of Spring Water - $8.20

+$8.00 Refundable Bottle Deposit

3-Gallon Jug of Spring Water - $6.95

+$8.00 Refundable Bottle Deposit

Case Prices

0.5 Liter (24 pack) - $13.65

20 ounce (24 pack) - $14.65

1.0 Liter (12 pack) - 13.75

Cooler Rentals

Premium Hot & Cold: $16.00/month

Standard Hot & Cold: $13.50/month

Cold and Room Temp: $11.00/month

Periodic Cleaning & Maintenance included.

Crock & Stand

Rental Crock & Stand: $5/month

Buy Crock Only-$45, Stand Only-$45

$10 off pair for new customers!

• Local Fresh Mountain Spring Water

• Locally owned, engaged and invested in our community

• Fast, responsive, and caring customer service

Blue Moon Water

Hours of Operation: 8am - 5pm

Phone: 828.253.6060

Email: info@BlueMoonWater.com

2002 Riverside Drive Suite 42-F
Asheville, North Carolina, 28804