Eco Chem Labs PDF

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Eco Chem Lab...

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NEW VENDOR INFORMATION FORM / CHANGE FORM This form must be completed and returned to Procurement before any orders will be placed q New Supplier q Updated Information Supplier Information: Legal Name: (This name must appear on all Invoices) Trade Name: (if different than Legal name) Eco Chem Labs Mailing Address: 258 Waverley Rd City: Province/State: Postal/Zip Code: Toronto, ON M4L 3T6 Telephone (s): Fax: Cell/Direct: 416-699-3028 Ordering Information x Same as Supplier Information Ordering Address: (to send Purchase Orders to) City:

Province/State:

Postal/Zip Code:

Contact Name: Title/Postion: Livia Lucchese Inside Sales Does your company accept credit cards, if yes, which one (s)? Does your company accept Purchase x YES q NO q VISA q MASTERCARD q AMEX Orders? Preferred Method of sending PO's to (please check one q Fax Number: [email protected] q Email: GST Number: Type of Business: 56-1247973 Hand Sanitizer GST Exempt Reason: Accounts Receivable Information x Same as Supplier Information Ordering Address: (to send Purchase Orders to) City:

Province/State:

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Same as Ordering Information

Postal/Zip Code:

Electronic Funds Transfer Information : Bank Name: Premium Banks Bank Transit Number: (5 digits) Bank ID Number: (3 digits) Bank Account Number: (7-12 digits) 53-3886388 ***Email address where remittance advice should be sent to (required if banking has been submitted)***: ap@Eco Chem Labs.com I hereby verify that the banking information provided is the current account for the above or attached company Printed Name Livia Lucchese

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Title/Position Inside Sales

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