VENDOR SETUP (FOR INTER-COMPANY USE ONLY) Employee Name
Date
Company Name Federal ID No.
Account No.
Purchasing Address City
State
Zip
Make checks payable to
(if different from Company Name)
Pay Address City
State
Phone
Fax
Website
Primary Contact
Phone
Fax
Zip
Sales Rep
Phone
Fax
FOR A/P DEPARTMENT USE ONLY
Account No. Entered By ALACK – North Shore 1010 W. Coleman Ave. Hammond, LA 70403 (985) 345-9476
Date SRE – Sarasota 5330 Pinkney Ave. Bldg. C Sarasota, FL 34233 (941) 924-1410
SRE – Fort Myers 1962 Honda Dr. Fort Myers, FL 33907 (239) 226-4555
LOTZ – New Orleans 5133 River Rd. Harahan, LA 70123 (504) 733-3790