ࡱ> LK \p Jean Kuehneln Holcombe Ba==h<L,8X@"1Arial1Arial1Arial1Arial1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1xArial1.Times New Roman1.Times New Roman1.Times New Roman1.xTimes New Roman1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1.Times New Roman1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)                + ) , *    #     !X+ !X+   +  h+ #X+  H+ "x +    !  (  ( !8 # !  8 &8 & #  (   (    &X &X " #8  @, & & & &8 "  & &8 &8  * ! 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Date:BI-LO Office Use OnlyVendor # Facility ID Inv Analyst # Load Building BackOrderN WHSE CodeTypeCityNameStateZip CodePhone FOB (D/O) Email AddressCUSTOMER SERVICE REPRESENTATIVEAddressAutoFax*3*If AutoFax # is local, the area code should be 000DUNSFaxEDI/4010 Capable?Yes/NoContactUCS#DUNS #REPRESENTATIVE INFO (Mail To)Broker #SHIPPING INFORMATIONEnter Y (Yes) or N (No)Prepaid/Common CarrierTruck Freight AllowType*Amount Prepay + AddRail Prepay+AddFreight Bill/IFDWater Freight BillBackhaulAir Backhaul RateLead Time Stated Other Up/DownFixed Delivery(M T W T F S S)Used for Leaker Allowance >>>>>BRACKET CLASSIFICATIONEffective Order QuantitySeqMinimumMaximum % DiscountCASH DISCOUNT TERMSBasePercentDay(s)Date of the MonthV E N D O R SHIPPOINTSDEnter the city, state and zip code FROM which the product is shippedFOB#Enter O (origin) or D (destination) CRP ANALYSTSEnter the name, phone, and Email Address for the CRP Representative, if applicable.CUSTOMER SERVICEREPRESENTATIVE[Enter the name, phone, Email Address, and AutoFax for the CS Representative, if applicable.EDI/4010 CAPABLEEnter Y for Yes; N for No6If Y, enter EDI contact name, phone number and DUNS #. MANUFACTURER\Vendor information - Enter the company name, address, city, state, zip code and phone numberINFO$(including area code) of the vendor.'Enter the DUNS # if you are EDI Capable Enter the contact person's name.USC #-Enter the Universal Communication Standard #..Enter the Email address of the contact person.)REPRESENTATIVE INFO (Mailing Information)YEnter the Broker # - if you enter the number, disregard the remaining rep information. fEnter the name, address, city, state, zip code, and phone number ( including area code) of the broker. Autofax #_Enter the AutoFax Number (including area code). If the number is a local number, the area codeshould be 000.Prepaid/Comm CarrierEnter Y (yes) or N (no) Lead Time Stated Water / AirbEnter M (Mon), T (Tues), W (Wed), Th (Thur), F (Fri), S (Sat), Su (Sunday) for the day of the week"$-.67?A when the item is being delivery.VENDOR ALLOWANCEFreight AllowanceRType - Enter the letter that represents how the item is shipped (see legend below)KAmount - Enter the amount of dollars for the freight allowance of this item@Amount - Enter the amount of dollars for the prepay of this itemHAmount - Enter the amount of dollars for the freight charge of this itemGAmount - Enter the amount of dollars for the backhaul rate of this itemS(NOTE: If a Backhaul rate is entered, the freight allowance must be completed, too)"Up/Down - Enter U (Up) or D (Down)IAmount - Enter the amount of dollars for the of this item *TYPES>>>>B (Cube)C (Truck Cube) D (Dollars) K (Truck Doz) L (Pounds)P (Truck Pallet)R- (Unit Truck S (Truck $) T (Truck CWT) U (Units)CWTY (Pallets)EOQEEnter a X next to the bracket number that BILO currently purchases in@Enter the letter that pertains to the order type for the bracketsL (Pounds); C (Cases); D (Dollars); B (Cubes); P (Pallets); Z (Dozens); X (Unit Factor One); or Y (Unit Factor Two)  $%/0<=HI`aEnter the minimum loadEnter the maximum load;Enter the discount percent in the cost between the brackets3Enter the % of discount if cash is used for paymentEnter the number of days Net/GrossEnter N (net) or G (gross)Enter the date of the month B I - L O.Enter the vendor # for this particular vendor.XEnter M (Mauldin), C (Chattanooga), B (Both) representing where the item will the stored$%MEnter the # pertains which Inventory Analyst is handling this category item. n 2 (Kay Kern); 6 (Barry Cain); 25 (Steve Turnmeyer); 28 (Brian Poeschel); 36 (Mark Osteen) or 90 (Marvin Leake) 46IK]_MEnter F (Forecast - CRP); B (Batch - Grocery/Freezer); O (Online) or N (None)78EF Backorder"This field will always be coded N. CEnter the # that reflects where in the warehouse the item is storedY Mauldin - 51 (Grocery Main); 50 (Grocery Sub); 11 (Freezer) or 60 (Temporary Perishables)  /1?A] Chattanooga - 51 (Grocery Main); 50 (Grocery Sub); 11 (Freezer) or 21 (Temporary Perishables) !#35CE,Enter V (Vendor Buying) or B (Broker Buying)MANUFACTURER INFO (supplier) Supplier #!Supplier ALLOWANCES/CHARGES/OTHERA(If no certificate of insurance the vendor will not be activated)6(Must be at least a 3 or vendor will not be activated)6If no D&B Scoring, references needed (can be attached)1_________________________________________________1D & B Scoring ___________________________________ AIs a "Certificate of Liability Insurance" attached? Yes __ No __(If Yes, fill out the following:Facility ID ____________Load Building _________WHSE Code ___________ Type ________Inventory Analyst # _______Holdback Fed ID/SSNQ(required if 1099 supplier/Unincorporated suppliers paid more than $600 annually) Net/Gross  Yes _____No _____*BILLING INFORMATION (remit to information)NAMEADDRESSCITYSTATEPHONEFAXCONTACTEMAILAccounting Signature (required)!Authorizer's Signature (required)!Negotiator's Signature (required)ZIP CODE _______CRP ANALYST (if applicable)  9SHIPPOINTS (Complete a separate sheet for each shippoint) Treasury Department Notes(Must be Director or higher) Supplier's Signature (required*)**Supplier's signature not required for PPO u3r[_Pa?r 4:8$AmN  = v% %"S#$az&a((\f)&.*Н0@@0ip0n<n<LE0 T0p Ot,D<T0t00h#l#9zm00  E000   ߿0 < t0<HPercent0]< 0ab0<,0\w0{T0T00Twe0Twբ0Tw|wwW|`T0yT0T0W|GW|$$W|9W|`w`T0`T0`T0xÆ0y`T0Ǭp0p000<<00<<S]00<t<<w$<P%0HHa0f2d@h*0vDate:BI-LO Office Use OnlyVendor # Facility ID Inv Analyst #  @:FS  dMbP?_*+%"&CBI-LO Warehouse Supplier Form&Q?'(\?(ffffff?) ףp= ?M \\b0maups1\003)W odXLetterCanon $ Canon iR330-400-P1/R1 PCL5edddd     ddd@@d     dd d     d d"  edddd     d!d     ddA     A d8o @@/ o @@/ d2CONFIDENTIALCONFIDENTIALHArial AXX\SRGBCO~1.ICM\SRGBCO~1.ICM\SRGBCO~1.ICMDefault Settings22"XXQ??U} } }  } } $ } } $} }  } I} } $ } $} $ @wwGD      0@lT0    \  VV    V XYYYZ[Z UWV  UV XZZZZZZ  U V XZZZZZZ mmZZZZZ        Z                            !    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