Vendor Application - National Convenience Distributors

New Supplier Request

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LEGAL BUSINESS INFORMATION

LEGAL BUSINESS NAME

D/B/A if different than above

PHYSICAL BUSINESS ADDRESS

State

SALES CONTACT FIRST NAME

SALES CONTACT LAST NAME

OFFICE TELEPHONE

SALES CONTACT EMAIL

BUSINESS INFO

BUSINESS TYPE

YEARS IN BUSINESS

TAX ID # / FEDERAL EIN

SUPPLIER DIVERSITY

SELECT ALL THAT APPLY

WEBSITE URL

REQUIRED BUSINESS FORMS regardless of State

Upload a copy of your W-9	Download W-9 Form if you do not have one
Upload a copy of your Certificate of Insurance (COI)	Read NCD's COI Requirements here

DESCRIPTION OF SERVICE OR PRODUCT CURRENTLY SUBMITTING

WHICH WOULD BEST CLASSIFY OUR RELATIONSHIP WITH YOUR COMPANY

Select either that apply or both

PLEASE ELABORATE ON THE PRODUCT OR PRODUCTS YOUR COMPANY WOULD LIKE TO PROVIDE TO NCD

PLEASE ELABORATE ON THE PROFESSIONAL SERVICE YOUR COMPANY WOULD LIKE TO PROVIDE TO NCD

OTHER? PLEASE EXPLAIN

Your product could be best classified in the following category: (choose all that apply)

Are you willing to offer any of your products/services as an exclusive to NCD?

YesNoMaybe

If no, can you tell us the other distributors you work with or where else we can find your product/service:

How did you hear about NCD?

Tell us which Industry Publication/Website, Event, Employee, NCD DIvision you are currently selling to or your Broker - so we can thank them!

Will NCD be working with your broker?

We are the BrokerYesNoMaybe

BROKER INFORMATION

Broker Business Name	Address Line 1
Address Line 2	City
State	Postal Code
Phone	Broker Contact First Name
Broker Contact Last Name	Broker Contact Direct Phone #
Broker Contact Direct Email Address

SOCIAL MEDIA if applicable

We are your partner and want to market your products/services. Growing your brand, strengthens our relationship. Tell us your social media profiles:

TWITTER @

FACEBOOK URL

INSTAGRAM @

SNAPCHAT @

YOUTUBE URL

LINKEDIN URL

PRODUCT, ORDERING & PAYMENT INFORMATION

BACKORDERS?

YesNo

PAYMENT TERMS %

Discount offered if paid within Terms Days

PAYMENT TERMS DAYS

# of days allowed to pay invoice for Discounted Terms eligibility.

NET TERMS REQUESTED

Invoice Paid within mandated period.

TERMS OTHER

PAYMENT TERMS note

UPLOAD NEGOTIATED OR PROPOSED VENDOR PROGRAM

HAVE YOU ALREADY NEGOTIATED AN AGREEMENT WITH OUR PROCUREMENT, FOOD SERVICE OR EXECUTIVE TEAM? OR DO YOU HAVE AN ENTICING OFFERING? UPLOAD IT HERE!

EMAIL ADDRESS TO SEND ORDERS TO:

LEAD TIME:

(IN DAYS)

DAMAGE PROGRAM:

Order Unit Type

MINIMUM ORDER:

NUMBERS ONLY
(Put 0 if N/A or no minimum)

MAXIMUM ORDER:

NUMBERS ONLY

DELIVERY POLICY / PROCEDURES (SHORTAGES, MISPICKS, DAMAGES, ETC.)

DELIVERY POLICY UPLOAD

RETURN & CREDIT POLICY INFORMATION

DO YOU HAVE A PRODUCT GUARANTEE / CREDIT POLICY

PRODUCT GUARANTEE - CREDIT POLICY UPLOAD

OTHER RETURN POLICY INFORMATION THAT SHOULD BE NOTED

RETURN POLICY UPLOAD

REMIT PAYMENT INFORMATION TO

PAYABLE TO

REMITTANCE ADDRESS

State

A/R TELEPHONE

A/R FAX

A/R CONTACT FIRST NAME

A/R CONTACT LAST NAME

A/R EMAIL ADDRESS

PAYMENT PREFERENCES

Your Payment Preference

CheckWireAmex

One Check per PO?

WIRE / EFT INFORMATION

BANK ABA ROUTING #	BANK ACCOUNT #
BANK NAME	BANK ADDRESS LINE 1
BANK ADDRESS LINE 2	BANK CITY
BANK STATE	BANK ZIPCODE
EFT DISCLAIMER This is to certify that National Convenience Distributors (NCD) may credit, using established banking industry EFT procedures, the bank account identified above to effect payment for vendor invoices received in accordance with the sales terms of those invoices. CHECK BOX TO VALIDATE

By checking this box, I understand that the submission of this form is simply a request to do business with NCD and not a guarantee that NCD will approve or accept the submission, partnership or service or product.

YOUR NEW VENDOR SUBMISSION WILL NOT BE RECEIVED AND PLACED IN OUR APPROVAL QUEUE UNTIL THE "CHECK BOX" ABOVE IS SELECTED, "NEXT PAGE" BUTTON IS CLICKED AND THE SUBMIT BUTTON ON THE NEXT PAGE IS CLICKED TOO!

National Convenience Distributors Purchasing Guidelines for Suppliers

The following purchasing terms are applicable to all suppliers of National Convenience Distributors (NCD).This document is not all inclusive and NCD has the right to adjust the requirements listed. In situations where the supplier’s policy is different from NCD, NCD Purchasing Guidelines will succeed. For further information, please contact NCD Purchasing Department.

New Products

Below are guidelines for new products.

Supplier agrees to complete the New Item Form completely and accurately.
Supplier agrees to pay NCD a $250 Administrative fee per new item. in addition to completing the New Item Form.
Upon receipt of the New Item Number, supplier will email NCD a picture of the product. The picture must be sent as a High Resolution Image with the item number as the file name. This must be received at least 30 days prior to selling the product.
Supplier guarantees all new products for a period 90 days. At the end of 90 days NCD and the supplier will reconcile all outstanding invoices and product to be returned.
If the suppliers’ new products sell completely and a second order is required, the suppliers guarantee will continue until the 90 day period expires.
If after 90 days a new product is not meeting the agreed upon sales targets, then the product can be discontinued by NCD. When a new or existing product has been active for 90 days or more, NCD may notify the supplier in writing to discontinue certain products. The supplier has 30 days to provide disposition instructions. At the end of 30 days, NCD will dispose the product and deduct the original cost of the product on the next payment to the supplier if NCD did not receive disposition instructions.

Product Data Management

Below are guidelines in order to properly capture the necessary information into our database.

Supplier provides a complete case of new product(s) to NCD IT Department at least 1 week prior to NCD selling the merchandise. This will ensure the consistent entry of information in NCD database. Additionally, it allows us to relay accurate information to our customers and to better promote the merchandise. Merchandise is sent to the attention of:

Director of IT Department

National Convenience Distributors

21 Banfi Plaza Farmingdale, NY 11735

Any advertising material or literature describing the contents and/ or ingredients will be provided by the supplier.
Samples will not be returned to the supplier, unless requested in writing and approved by the Purchasing Department in advance.
Failure to comply may delay the availability of sale and delivery of merchandise to our customers and eventual rejection and cancellation of the purchase order.

Swell Allowances

Below are guidelines for swell allowances.

Allowances for swell, spoilage, and damages are created to reimburse NCD for all unsaleable merchandise.
Swell Allowances cover routine, day-to-day damages and spoilage.
Swell Allowances do not cover discontinued products, recalls or defective products.
NCD has the right to renegotiate Swell Allowances with suppliers if the Swell Allowances provided do not cover the cost of the product being processed or discarded.

Recalls, Discontinued or Defective Products

Below are guidelines for Recalls, Discontinued or Defective Products.

The supplier will notify NCD of any recalls, discontinued or defective products in writing.
The supplier is responsible for all costs of these products and removals.
The supplier will reimburse NCD for the original cost of the items.
The supplier will compensate NCD for any costs incurred by NCD.

Certificate of Insurance

A current Certificate of Insurance must be provided with the following:

Workers’ Compensation – Statutory Limits
General Liability (including products/ completed operations)

- $2,000,000 General Aggregate
- $2,000,000 Products/ Completed Operations Aggregate
- $1,000,000 Each Occurrence
- $1,000,000 Personal and Advertising Injury

Certificate Holder – National Convenience Distributors 21 Banfi Plaza Farmingdale, NY 11735
Additional Insured – National Convenience Distributors and their respective Subsidiaries, Officers, Directors and employees of each are included as an additional insured.
Policy Issued on Occurrence Basis
Automobile Insurance
Minimum 30 day written notice of cancellation or change in insurance coverage.
As policies are renewed, a current COI should be issued to National Convenience Distributors.

Miscellaneous

Suppliers will provide NCD with Material Safety Data Sheets when applicable.
NCD does not accept UPS freight.

For more information, please contact NCD Purchasing Department.

By signing this digital form, I acknowledge the Purchasing Guidelines and will abide by them.

YOUR NEW VENDOR SUBMISSION WILL NOT BE RECEIVED AND PLACED IN OUR APPROVAL QUEUE UNTIL THE "SUBMIT" BUTTON IS CLICKED BELOW, YOU SIGN ON THE NEXT PAGE AND HIT THE FINAL SUBMIT BUTTON!

Save my progress and resume later | Resume a previously saved form

New Supplier Request

Download W-9 Form if you do not have one

Read NCD's COI Requirements here

YOUR NEW VENDOR SUBMISSION WILL NOT BE RECEIVED AND PLACED IN OUR APPROVAL QUEUE UNTIL THE "CHECK BOX" ABOVE IS SELECTED, "NEXT PAGE" BUTTON IS CLICKED AND THE SUBMIT BUTTON ON THE NEXT PAGE IS CLICKED TOO!

YOUR NEW VENDOR SUBMISSION WILL NOT BE RECEIVED AND PLACED IN OUR APPROVAL QUEUE UNTIL THE "SUBMIT" BUTTON IS CLICKED BELOW, YOU SIGN ON THE NEXT PAGE AND HIT THE FINAL SUBMIT BUTTON!