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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

Email

Website

Primary Contact

Phone

Fax

Zip

Email

Sales Rep

Phone

Fax

Email

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

vendor-setup-form-lafl-editable  
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