Prospective Supplier Profile Form

Prospective Supplier Application

We always welcome the interest we get from manufacturers who want us to represent their line. We sincerely wish to return the consideration by making an informed decision and having an intelligent dialogue with you about the possibilities of working together. Please complete this form and send along with your catalog and price list to:

Product Manager
C/O Jeff Garb & Associates
PO Box 351
Needham, MA 02494
email: info at repgroup.com

www.repgroup.com

If you need to send us a carton, please call 800-456-8697 for our physical street address.

Basic Information (Please complete all* for proper consideration)

Today's Date: _______

1) Your Company Name: (include all trade names & brand names)_______________________________________________________________

2) Send Invoices to Address_____________________________________________

3) Warehouse Address____________________________________________________

4) Email Address to send orders to:_____________________________________

5) Your Web Site________________________________________________________

6) Do you have a catalog and price list?  __Yes  _No

7) Owners Name________________________ Phone_______________ Email Address__________

8) Sales Managers Name________________ Phone________________ Email Address_________

9) Which email address should we reply to this questionnaire_?______________________

10) How long in business? ____

11) Commission Rate ___%

12) You pay commissions on (check one)

___UPON RECEIPT OF PAYMENT FROM CUSTOMER

___MONTHLY AFTER INVOICING

13) You are looking for coverage in what states? :

(Circle) STATES that apply: MA RI CT NH VT ME NJ NY

14) Select the best response:

__You will provide first time customers with n30 terms with references Y/N

__You only will do first time orders on credit card but will check refs for future orders on n30

__You only accept credit cards, no terms granted

15) If you supply products to be used by children 12 and under, what is the website location for Certificate of Compliance for each item?__________________________

16) Describe your merchandise in detail__________________________________________________________________

17) Best Selling Items _____________________________________________________

18) Your Biggest

Competitors_______________________________________________________________

19)Best Type of Retailers to be Targeted:____________________________________

20) Previous Representative in this territory_________________________________

21) Please list three other representatives you have been using for at least 12 months_____________________________________________________

22) Please list six of your current customers in our territory_________________________________________________________________________________________________________________________________________________________

23) What were your sales in our territory for the preceding 12 months__________

24) What are your realistic sales goals for our territory for the next 12 months________

25) Will you commit to sending us a “flat file” Excel product listing each time you update your prices, add or delete items? (each product listed in one row and a column for Item Number, Description, Price, Minimum, Availability Date, and UPC or EAN Code) Y/N

26) Do your commission statements include your company name, name of the account, account city, state, ship date, purchase order number, invoice number, dollar amount of the order less shipping charges, and the commission amount for each invoice? Y/N

27) Do you send commission checks along with the statement? Y/N

28) Will you provide a complete Customer List, with customer number, YTD and LYTD sales figures?  We will use this information to create historical sales data to assure that all of your existing accounts receive uninterrupted service? Y/N

29) Will you mail all of your existing customers a letter announcing the rep change? Y/N

30) Do you agree that all rep road samples are sent free of charge without any expectation of their being returned and become our property for us to use at our discretion? Y/N

31) Please List the House Accounts in the territory that are not commissionable____________________________________________________________________________________________________________________________________________________

32) We will be paid on all direct orders originating from our territory? Y/N

33) You agree to pay our group for all direct orders from the territory regardless of how it is received (email, fax, web etc) and for all customers regardless of ‘converting a customer’ etc with the exception of the above listed house accounts? Y/N

34) You agree that either you or All Roads East, Inc may terminate the relationship with 30 days written notice and that commission will be paid on all orders written during and before the end of the 30 day period no matter when the merchandise ships? Y/N

35) You agree that you or your agents and/or representatives will not attempt or hire any of our representatives as your sales agents in this territory either during our active engagement as your reps or for a period of 12 months after the last date of termination? Y/N

36) Opening order minimum_$________

37) Reorder Min $______

38) When a rep or a customer calls your company what percent of the time will they get a live person %_______

39) Are you selling to either Walmart or Target? Y/N

40) How did you hear about us?

____Referral (who please___________________________________)

___Web Search (what key words please_______________________)

___From a link (who's link please__________________________)

___Other Source (which please______________________________)

Any other comments:_____________________________________________

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