Supplier Profile Form

To join our empactMarketplace as a supplier, please complete the following on-line form and submit it by pressing the Send button at the end of the form. We will send you a username and password in the near future after processing your information.

Company Information
Company Name:
Corporate Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:
Website Address (URL):

Contact Information
Name Phone E-mail
Company President / CEO:
National Account Contact:
National Account Contact Reports To:
Information Technology Contact:
Ecommerce Contact:
CFO:
Contract Manager:

Sales Information:
List your lines of business and annual sales volume for each:
Lines of Business Annual Sales Volume
Total:
 
What is your average dollar amount per PO?
What is your estimated % of annual dollar volume lost to non-compliance? %
What is your estimated annual customer service expense as it relates to order processing, invoice reconciliation, contract management, and product research (e.g. FTE's x Average salary/benefits)?
 
What % (estimate as necessary) of your business comes from each of the following sources?
Phone: % EDI: % OBL: %
Mail: % E-mail: % Web: %
Fax: % XML: % Other: %
 
Please list your distributors:
 
Please list all group purchasing organizations with which you are affiliated and the % of business each GPO represents:
Group Purchasing Organization % of Business
%
%
%
%
%
%
%
%
%
%
What % of your business is through distribution? %
 
Product Information
Approximately how many inventory items (SKUs or Stock Keeping Units) do you have?
How often do you update your catalog content?
Annually Semi-annually Quarterly
Monthly Weekly Daily
How frequently do you update your customer price lists?
Annually Semi-annually Quarterly
Monthly Weekly Daily
Are there special requirements for ordering your products?Yes No
If yes, please explain (i.e. minimum order requirements, tiered pricing, configuration tools needed):
What sorts of product promotions and/or specials are common with your company?
Sales Promotions Conversions from other vendor pricing
New product specials Guaranteed savings
Volume pricing Discounts for early payment
Rebates Other (please provide a short explanation)   

Information Technology
What Enterprise Resource Planning (ERP) system does your company have?
Baan Peoplesoft
Oracle SAP
J.D. Edwards Proprietary
Lawson Other (please explain)   
What computer operating system does your ERP system use?
Windows NT UNIX
Other (please explain)   
What database does it use?

Internet Information
Does your company have an internal intranet? Yes No
Does your company participate on an extranet with customers?
Yes No    Explain
Approximately how many of your employees have access and/or authorization to use the Internet?
All over 50%
25%-50% under 25%
What type of electronic commerce initiatives are you currently involved in?
Do you have an electronic catalog that includes product description? Yes No
If yes, what percentage of the items have a product description? %
Does it include pictures? Yes No
If so, what format?
Access Quark/Pagemaker
Text Excel
HTML Other (please explain)    
How do you manage your catalog content with respect to your commodity space?
In house, who is responsible?
3rd party, who are you using?


Please review your registration information for accuracy, particularly your phone number and e-mail, in case we need to contact you. To print this page for your records, select the Print command from the menu of your internet browser. Press the Send button below to submit your form on-line.