Cvs New Vendor Information Form - Ecrm Page 3
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1
2
3Merchandise Return Address
Warehouse Return
Name
Store Return
Name
Street
City/State
Street
City/State
Zip
Phone
Zip
Phone
Information for Electronic delivery of PO:
Please visit
EDI Info
EDI Customer Service Info
Import
Yes
No
EDI Capable
Yes
No
Contact Name
EDI Contact
Fax #
Email Address
Email Address
Phone #
Fax #
Phone #
Ship From Address
Where merchandise will be shipped from –If product ships from multi-locations, utilize Ship From Address 2
Address 1
Address 2
Warehouse Contact Name
Warehouse
Contact Name
City/State
City/State
Zip
Phone #
Zip
Phone #
Backhaul Data
Required to identify program availability and central point of contact.
Do you offer a backhaul program from Address 1 above?
Yes
No
Do you offer a backhaul program from Address 2 above?
Yes
No
Do you offer collect pricing?
Yes
No
Do you offer collect pricing?
Yes
No
Backhaul Contact Name
Backhaul Contact Name
Contact phone #
Contact phone #
Vendor Signature
CVS Authorized Signature
rd
cc: EDI Dept, Cathy Petrarca-ECR, Dennis Berard-Log 3
Flr
CVS Financial Approval Signature
MER-91 Revised 3-1-04
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Parent category: Business