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Supplier Information Sheet

The document is a supplier information sheet for Mercury Drug that collects various details about a supplier's company, products, marketing and sales forecasts, accreditation policies, and required documents. It requests information on a supplier's marketing channels, distributors, annual sales projections by region, policies on product returns and promotions, documentation required for accreditation, and a section for Mercury Drug to record the application status.

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Josehermes Santos Estillore
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© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
245 views

Supplier Information Sheet

The document is a supplier information sheet for Mercury Drug that collects various details about a supplier's company, products, marketing and sales forecasts, accreditation policies, and required documents. It requests information on a supplier's marketing channels, distributors, annual sales projections by region, policies on product returns and promotions, documentation required for accreditation, and a section for Mercury Drug to record the application status.

Uploaded by

Josehermes Santos Estillore
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SUPPLIER INFORMATION SHEET

B. 1 MARKETING & PROMOTIONS (Please check all that applies):

/ / ETHICAL / / DIGITAL / / PRINT / / T.V. / / RADIO / / CINEMA

Scope of Coverage / / National / / GMA only / / Provincial _____________

B. 2 DISTRUBUTOR (Please check all that applies) :

/ / DRUGSTORES / /SUPERMARKET / / CLINICS / DISPENSING DOCTORS

/ / HOSPITALS / / GOVERNMENT / / CONVENIENCE STORES ONLY

/ / OTHERS ____________________

B. 3 SALES FORECAST
YEAR 1 YEAR 2 YEAR 3
METRO MANILA P P P_______________________
LUZON P P P_______________________
VISAYAS P P P_______________________
MINDANAO P P_______________________ P_______________________
SECTION C : ACCREDITATION POLICY
1. MUTUALLY AGREED TERMS & DISCOUNT COVERED BY A SIGNED AGREEMENT
2. NEW STOCKS UNDER CONSIGNMENT BASIS. NON-MOVING OR SLOW MOVING OFFERED PRODUCTS SUBJECT TO RETURN AFTER A
PERIOD OF 6-MONTHS.
3. ALL P PROMOTIONS & MARKETING RELATED ACTIVITIES AND USE OF MERCURY DRUG TAGLINE MUST BE APPROVED BY MERCURY
DRUG PRIOR TO ITS IMPLEMENTATION.
4. ADVERTISING MATERIALS MUST BE APPROVED BY GOVERNING BODIES PRIOR TO USE AND SHOULD BE THE RESPONSIBILITY OF
SUPPLIER TO SEEK AND HANDLE APPROVAL PROCESS.
5. GIVING OG GIFTS & INCENTIVE SCHEMES TO ANY PERSONNEL OF MERCURY DRUG CORP ARE STRICTLY NOT ALLOWED. CONFIRMED
VIOLATION WILL RESULT TO TERMINATION OF ACCREDITATION.
6. ANY AGREEMENT ARRICED AT DURING TRANSACTION IS BINDING AND EXECUTORY.
SECTION D : DOCUMENTS REQUIRED
1. PROPOSAL LETTER WITH PRODUCT AND PRICES. / /
2. ACTUAL PRODUCT WITH LITERATURE AND OTHER DETAILING PROMOTIONAL MATERIALS. / /
3. FOOD & DRUG ADMINISTRATION (FDA) VALID LICENSE TO OPERATE (LTO) / /
4. CERTIFICATE OF PRODUCT REGISTRATION (CPR) FROM FDA / NMIS / OR OTHER GOVERNING BODY THAT APPLIES / /
CERTIFICATE OF EXEMPTION, IN CASE OF EXEMPTION. / /
5. FDA CERTIFICATION OF GOOD MANUFACTURING PRACTICE (CGMP) / /
FOR FOOD PRODUCT INCLUDE HAZARD ANALYSIS & CRITICAL CONTROL POINTS FROM FDA / /
6. SANITARY PERMIT. / /
7. BIR FORM 2303 CERTIFICATE OF REGISTRATION & COPY OF LATEST INCOME TAX RETURN / /
8. MUNICIPAL BUSINESS LICENSE & PERMIT. / /
9. SEC/DTI REGISTRATION / /
10. ARTICLES OF PARTNERSHIP / ARTICLES OF INCORPORATION. / /
11. ORGANIZATIONAL STRUCTURE WITH NAMES OF OFFICERS. / /
12. PHOTOGRAPH & SKETCH OF BUSINESS ADDRESS. / /
CONFORME:
SIGNATURE (AUTHORIZED SIGNATORY} ____________________________
PRINTED NAME ____________________________
POSITION ____________________________
SECTION E : ACCREDITATION STATUS – MDC TO FILL-OUT
APPLICATION RECEIVED BY ______________ DATE ______________ TIME _____________
/ / RECOMMENDED FOR ACCREDITATION / / NOT REMMENDED FOR ACCREDITATION
REASONS: ______________________________
BUYER: ______________________________ ______________________________________
FOR DISTRIBUTION TO THE FOLLOWING
/ / A. ALL MERCURY DRUG STORES / / D. VISMIN STORES ONLY
/ / B. METRO MANILA SOTRES ONLY / / E. TRINITY STORES ONLY
NO.
MDC FORM
PD 02 No. 7 Mercury Avenue Corner C P Garcia Bagumbayan, 110 Quezon City Philippines DATE:
Telephone No. (632) 911-5071 to 87 Fax No. (632) 911-6684 Email [email protected]

SUPPLIER INFORMATION SHEET


SECTION A : COMPANY INFORMATION
COMPANY NAME : ____________________________________________ BUSINESS OPERATION :
OFFICE ADDRESS : / / Importer
____________________________________________ / / Manufacturer
TELEPHONE NOS. : Direct Nos._______________________________________ / / Distributor
Cell Nos._________________________________________ / / Marketing Company
FAX NUMBER :_____________________________________________ No. of Years in Business :
E-MAIL ADDRESS :_____________________________________________ ________
WEBSITE :_____________________________________________ TIN: ____________________
DISTRIBUTOR:______________________________________________________________________
BUSINESS OWNERSHIP :
/ / SINGLE PROPREITORSHIP / / PARTNERSHIP
/ / COPORATION / / OTHERS ________________
NAME OF OWNERS : %SHARE
1 ________________________________________________ ________________
2 ________________________________________________ ________________
3 ________________________________________________ ________________
4 ________________________________________________ ________________
5 ________________________________________________ ________________
COMPANY OFFICIALS : POSITION
1 ________________________________________________ ________________
2 ________________________________________________ ________________
3 ________________________________________________ ________________
4 ________________________________________________ ________________
5 ______________________________________ __________ ________________
NUMBER OF FIELD SALES PERSONNEL :
IS ANY OF YOUR OWNERS, OFFICERS OR IF YES, Please state complete name:
EMPLOYEES RELATED TO ANY OFFICER OR 1. _____________________________
EMPLOYEE OF MERCURY DRUG? Relationship ____________________
2. ____________________________
/ / NO / / YES Relationship ____________________

SECTION B: BUSINESS OPERATION


OFFERED PRODUCTS: MANUFACTURER : SOURCE COUNTRY :
1.________________________ ________________________ _____________________
2.________________________ ________________________ _____________________
3.________________________ ________________________ _____________________
4.________________________ ________________________ _____________________

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