Select Page

Supplier Intake Application Form

Supplier Intake Form
of contact person
Address *
Address
City
State/Province
Zip/Postal
Country
Company Type *
I can provide evidence that my products are manufactured in an approved facility *
Does your manufacturing/supply facility have an export license? *
Can you provide the physical address of your manufacturing/supply facility on request, and are you prepared for it to be physically inspected by agents of the buyer? *
Incoterms for [X] *
Payment terms *
Have you sold medical equipment before? If so, please provide information about applicable references or contract vehicles.
How did you hear about us?
en English
ar Arabicen Englishfr Frenchpt Portuguese