7/23/2019 Request for Supplier Info

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REQUEST FOR SUPPLIER INFORMATION

COMPANY NAME: _____________________________  VENDOR #: _______________________________   (TO BE ASSIGNED BY PURCHASING)

ADDRESS:  _____________________________  REMIT TO:  ______________________________ 

  _____________________________ _______________________________ 

  TELEPHONE #: _____________________________ FAX #: _______________________________ 

FREIGHT TERMS:   CONSIGNEE/PREPAID CONSIGNEE/PREPAID & ALLOWED

  CONSIGNEE/COLLECT CONSIGNEE/COLLECT & ALLOWED

  ORIGINATOR/PREPAID ORIGINATOR/PREPAID & ALLOWED

  ORIGINATOR/COLLECT ORIGINATOR/COLLECT & ALLOWED

  OTHER _________________________ 

  SHIP VIA:   BEST MEANS CUSTOMER PICK UP

  UPS VENDOR

OTHER __________________________ 

PAYMENT TERMS:  NET 30 NET 10

  OTHER __________________________ 

DISCOUNT TERMS: 2% ___ DAYS/NET _____ 10% ___ DAYS/NET ______ 

  OTHER __________________________ 

  TAXABLE: YES   NO DEPENDS ON ITEMS PURCHASED

FEDERAL TAX ID NO. SS#

COMPANY NAME ONCERTIFICATE

COMPANY ADDRESSON CERTIFICATE

STATUS PROPRIETORSHIP CORPORATION PARTNERSHIP

CONTACT PERSON

PLANT MGR APPROVAL:_________________________ REQUESTED BY:____________________________ 

CONTROLLER APPROVAL:________________________ COMPLETED BY: __________________________   (PURCHASING DEPT PERSONNEL