BexarMet Supplier and Vendor Qualification Form

Vendors interested in doing business with BexarMet should complete this form. For more information on this form, contact the BexarMet Purchasing Department at (210) 354-6506.

PLEASE SUBMIT CURRENT ANNUAL REPORT IF A PUBLIC COMPANY OR IF NOT, CURRENT FINANCIAL STATEMENTS.

Please forward via U.S. Mail any catalogs, advertisements, etc., that will enhance your company's qualifications.

If qualified to do business with BexarMet, a letter to this effect will be mailed to the contact person indicated on this form.

Full Supplier Company Name: *

Main Office Information

Street Address: *

City: *

State: *

Please use two letter abbreviation.

Zip Code: *

Please provide ten digit zip code if possible.

Telephone: *

Fax: *

Website Address:

Distribution Point(s):

Sales Contact Individual

Name:

Phone Number:

Email:

Sales Manager

Name:

Phone Number:

Email:

President/CEO Name and Title:

Name and Location of Parent Company:

Type of Organization

Proprietorship:

Partnership:

Corporation:

Years in Business:

General Description of Facilities:

Description of Equipment:

Primary Area(s) of Expertise:

Other Area(s) of Expertise:

Payment Terms:

F.O.B.:

Delivery Times (ARO):

Do You Accept Purchase Orders?: *

Please answer "Yes" or "No."

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