Short Form Offer to Purchase

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					                                        Short-Term Deal Form for AHOLD USA                                                                                            * Denotes Supplier Required Field                                                                              Total Sales Estimate:                                                                            OpCo/SupCo Deal #:                                                                     Funding Percent:

                    * Company Presented to:                                                                                                                                * Confirmation Contact Name:                                                                         Total Est. Allowance Amt:                                                                                     Account Code:

                       * Manufacturer / Brand:                                                                                           DSD ?                             * Confirmation Contact Phone:                                                                            Total Estimated Profit:                                                                               Accounting Initials:
                                                                                                                                                                                                                                                                                                  Suppliers - Check One (For Giant-C use only)
                 * Broker / Distributor Name:                                                                                        Yes / No                          * Confirmation Contact Address:
                                                                                                                                                                                                                                                                                      Groc 7059    Froz 1603 I/C 1604 Bkry 1602 Meat 1607 Std 1608
                                                                                                                                                                                                                                                                         C&S NEO      ________    ________ _______ ________ ________ _______                                       Sherwood  22893 ________                      PDC       99910 ________
                               * Date Submitted:                                                                                                                             * Supplier Authorizer Name:                                                                 C&S HBG      ________     ________ _______ ________ ________ _______                                      ASC         414 ________                      Millbrook 8806 ________
                                                                                                                                                                                                                                                                         C&S ADR      ________    ________ _______ ________ ________ _______                                       C&S PA&MD 1724 ________                       B-KWIK     7059 ________
                                 * Submitted By:                                                                                                                              * Supplier Authorizer Title:                                                               C&S WNY      ________    ________ _______ ________ ________ _______                                       C&S VA&WV 1725 ________                       DSD             ________

                      Ahold Negotiator Name:                                                                                                                                * Supplier Authorizer Phone:                                                                                                                                       Additional Terms and Conditions
                                                                                                                                                                                                                                                                                                  Supplier agrees to confirm the terms of this supplier Promotional Offer promptly upon request from Ahold USA or its independent auditor, provided that before
                                                                                                                                                             * Supplier Authorizer
                Ahold Negotiator Signature:                                                                                                                                                                                                                                            1          responding to a request from an auditor or other individual not known to supplier, supplier shall first confirm the identity of the requestor with supplier's principal
                                                                                                                                                                        Signature:                                                                                                                contact at Ahold USA.
                                                                                                                                                       I certify that this information contains all of the terms and conditions of this supplier Promotional Offer and
                   Ahold Negotiator Buyer #:                                                                                                                                                                                                                                           2          Ahold USA shall have no obligation to purchase any new product or item for any specific period of time. Ahold retains the right to set retail prices.
                                                                                                                                                       may not be altered by side letters or by oral agreements. However, if there is a supply agreement covering
                                                                                                                                                       purchase of the same product from the same company over the same term and there is a conflict between
         2nd Negotiator Name & Signature:                                                                                                                                                                                                                                                         If an Item Number is inadvertently omitted or incorrect, we reserve the right to add or correct the item number without affecting the essence and/or terms of the
                                                                                                                                                       the information on this form and such supply agreement, the terms of the supply agreement shall prevail.                        3
                              (if required)                                                                                                                                                                                                                                                       agreement.
                                                                                                                                                       The Supplier's signature above certifies he/she is authorized to present this offer and that the Supplier has
                                                                                                                                                                                                                                                                                                  In the event the supplier's stated allowance uses a different unit of measure from that of the case pack received by the OpCo, the OpCo can make a proportional
                      Ahold Authorizer Name:                                                                                                           not made any changes to the form of the document as submitted by Ahold USA.                                                     4          adjustment without requiring a new deal sheet.

                                                                                                                                                                                                                                                                                       5          No restrictions on Forward Buys unless otherwise noted in the comments field.
                        Ahold Authorizer Title:                                                                                                                               Supplier Deal Reference #:
                                                                                                                                                                                                                                                                                       6          Load-in and restock policy apply
                                                                                                                                                                                                                                                                                       7          There is a 10% up charge on Scans. (4.5% for Stop&Shop / Giant-L only)
       Ahold Authorizer Signature & Date:                                                                                                                                                   A/R Supplier #:
       2nd Ahold Authorizer Signature & Date:                                                                                                                                                                                                                                              Allowance Type                                                     Allowance Type                                                    Allowance Type
                                                                                                                                                                                    Op Co/SupCo A/R #:
                                  (if required)

    * Stock Protection?                 Yes / No                           * National Deal?                   Yes / No                                                                                                                                                                      Component 1                                                         Component 2                                                       Component 3
                                                                                                                                                                                        DSD / PO Vendor #:
                 * Merchandising Deal Type:                                                                                                                                                                                                                              * Deal Number:                                                * Deal Number:                                                    * Deal Number:

             * Order Dates:                                                       thru                                                                                              Extended Dating / Special Cash Terms                                                  * Perf. Dates:                                                  * Perf. Date:                                                     * Perf. Date:

               * Ship Dates:                                                      thru                                                                                                                                                                                   * Performance:                                                * Performance:                                                       * Performance:

            * Arrival Dates:                                                      thru                                                                                                                                                                                         * Payment Method:                                             * Payment Method:                                                 * Payment Method:

 * Anticipated Next Deal Date:                                                                                                                                                                                                                                              * Calculation Method:                                         * Calculation Method:                                            * Calculation Method:

                                                                                                                                                                                                                                                                             * Computation Basis:                                          * Computation Basis:                                             * Computation Basis:
                                                                                                                                                                                                                                                                                                Case                   Unit                                        Case                    Unit                                      Case                  Unit
                                                                                                                                                                              Unit of           Case                                 Regular             Regular                                                                                                                                                                                                            * Estimated   * Suggested                     Estimated
   #         OpCo Item #                 SupCo Item #                             UPC                                    Description                         Size                                                OpCo Use                                                                    Allowance              Allowance                                   Allowance               Allowance                                 Allowance             Allowance                                         Net Unit Cost
                                                                                                                                                                             Measure            Pack                                Case Cost            Unit Cost         * Allowance                                                    * Allowance                                                        * Allowance                                                      Volume       Unit Retail                      Profit
                                                                                                                                                                                                                                                                                              Amount                 Amount                                      Amount                  Amount                                    Amount                Amount


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Division/Store/Warehouse/Grouping Comments:                                                                                                                                                                                                                                      Additional or OpCo/SupCo-Specific                                Additional or OpCo/SupCo-Specific                                 Additional or OpCo/SupCo-Specific                                                        (Part 1)
                                                                                                                                                                                                                                                                                    Performance Requirements                                         Performance Requirements                                          Performance Requirements                                                              TOTAL

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 (Part 1) Value of
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Components 1,2,3




                                                                                                                                                                           Greater than
comp.                                                                                                      Allowance Type                                                                        Payment Method                      Performance Indicator               Deal Number          Acct #                 Amount                        Additional Performance Details                             Estimated Value of Deal
                                                                                                                                                                             1 week

   4                          Flat                                                                                                                                          Yes / No
                           Payments
   5        (Ad, Display, Truckload, Item Intro Fee,                                                                                                                        Yes / No
                              etc.)
   6                                                                                                                                                                        Yes / No

                                                                                                                                                                                                                                                                                                                                                                                          TOTAL
Operating Company Specific Instructions:
Stop&Shop Only:
--Supplier should specify the specific performance type in the "Additional Performance Requirements Field" (example: 1/2 price, bogo, 1/3 off, TPR, super special, etc.)
--Giant Merchandiser to indicate prepaid deduction steps to be taken by Accounting.
Giant Carlisle Only:
--Signing this document implies agreement to supplying labor or funding to this company to perform In Store Execution activities.
--Manufacturers are responsible for reimbursement of discontinued product billings generated through the merchandising department.

Additional Notes:




                      Print Date: 8/22/2011                                                                                                                                                                                                                                                                                                                                                                                                                                                               Release 6.6
                      d3ccff72-2eb8-43b6-8bfb-8725ce52d0d9.xls                                                                                                                                                                                               Page 1 of 2                                                                                                                                                                                                                     Last Revised: 10/16/2006
                                  Short-Term Deal Form for AHOLD USA                                                                                                                               * Denotes Supplier Required Field
                                                                                                                                                                                  Allowance Type                                 Allowance Type                                 Allowance Type
         * Company Presented to:                                                 Op Co/SupCo Deal #:

           * Manufacturer / Brand:                                              DSD / PO Vendor #:                                                                                  Component 1                                   Component 2                                    Component 3

      * Broker / Distributor Name:                                              * Supplier Authorizer
                                                                                                                                                              * Deal Number:                                   * Deal Number:                                 * Deal Number:
                                                                                               Name:
                   * Date Submitted:                                            * Supplier Authorizer                                                                                                                                                                                                                             Continued from Page 1.
                                                                                                                                                                * Perf. Dates:                                   * Perf. Date:                                  * Perf. Date:
                                                                                                Title:
                    * Submitted By:                                             * Supplier Authorizer
                                                                                                                                                                * Performance:                                  * Performance:                                 * Performance:
                                                                                              Phone:
          Ahold Negotiator Name:                                                                                                                                       * Payment Method:                          * Payment Method:                              * Payment Method:

                                                                                                                                                                     * Calculation Method:                      * Calculation Method:                          * Calculation Method:

                                                                                                                                                                     * Computation Basis:                        * Computation Basis:                          * Computation Basis:
                                                                                                                                                                                       Case           Unit                           Case            Unit                            Case           Unit
                                                                                                          Unit of   Case               Regular     Regular                                                                                                                                                   * Estimated   * Suggested                       Estimated
#    OpCo Item #          SupCo Item #          UPC               Description               Size                           OpCo Use                                                 Allowance      Allowance                      Allowance       Allowance                       Allowance      Allowance                                 Net Unit Cost
                                                                                                         Measure    Pack              Case Cost   Unit Cost      * Allowance                                     * Allowance                                    * Allowance                                    Volume       Unit Retail                        Profit
                                                                                                                                                                                     Amount         Amount                         Amount          Amount                          Amount         Amount


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                                                                                                                                                                                                                                                                                                                             (Part 2)
                                                                                                                                                                                                                                                                                                                              Total

                                                                                                                                                                                                                                                              Total allowance amount                                             (Part 2) Value of
                                                                                                                                                                                                                                                              from attached list (if any):                                      Components 1,2,3




                                                                                                                                                                                                                                                                                                                                                   Release 6.5
     d3ccff72-2eb8-43b6-8bfb-8725ce52d0d9.xls                                                                                                          Page 2 of 2                                                                                                                                                                      Last Revised: 4/15/2006

				
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Description: Short Form Offer to Purchase document sample