Change in Contract

							                                                           BI-LO DSD
                                                     COST CHANGE CONTRACT
1) Buyer Name or Number:                                                                            RETAIL ZONES:


2) Vendor Type:                 DSD

3) New Cost Effective Date:

4) Vendor #                     Vendor Name:                                                        COST ZONE
                                                                                                    Stores:
5) Old Cost:

6) New Case Cost
  Bracket(s)     NEW COST           RETAIL            Qty


7) Items

     UPC              Item                                            Pack           UPC     Item                               Pack
    Number            Code         Description                        Size          Number   Code   Description                 Size




Date Received _____________________

Date Entered _____________________

Representative Signature:       __________________

The above signed or unsigned guarantees the cost change is being given to all the
retailers in the marketplace.

IMPORTANT: A manufacturer's deal sheet must be attached to this form.

                                                                                                                    12/9/2010
    Vendor Name:                                            Stores:
  Vendor Number:
       Cost Zone:

Prod ID   UPC       Order #   Description                 Size        Old Cost   Pack   New Cost   Start Date




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