New Vendor Intake Form Business Contact InformationBusiness NameAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Key Contact Name First Last Key Contact PhoneKey Contact Email Broker RepresentationSelection OptionYesNoBroker Business NameBroker Key Contact Name First Last Broker Key Contact PhoneBroker Key Contact Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Key Contact for Confirming / Tracking OrdersSelection OptionSame as above provided Key ContactSomeone elseOrders Key Contact Name First Last Orders Key Contact PhoneOrders Key Contact Email Ordering & PaymentOrder Trasmission Email Lead timeOrder minimumIf by pallet, specify # of cases per pallet (if variance by SKU, use average #). Order requirementsBy pallet, layer, etc. and other pertinent details. Damage / OOD HandlingSelect OptionBill back & disposeHold for reviewRack PolicyDescribe lead time, costs, ordering method, is a contract required, ship direct to store or MR Williams, etc. Payment termsUpload logoMax. file size: 50 MB.Upload signed W9Max. file size: 50 MB.Upload Certifications of Liability Drop files here or Select files Max. file size: 50 MB. MR Williams requires two certificates, each with a minimum of $1 million in coverage. List M.R. Williams, Inc. at 235 Raleigh Rd. Henderson, NC 27536 as the certificate holder on one, and M.M. Fowler, Inc. D/B/A Family Fare at 4220 Neal Road Durham, NC 27705 on the other.
