Supplier Information Submission Supplier Information Submission Company Name*Address* Street Address Address Line 2 City County Postcode Company Fax NumberCompany Email* Company VAT Number*Manager/Director* Name Telephone Number Fax Number Email Technical Contact* Name Telephone Number Fax Number Email This field is required. If you do not have a Technical Contact, please indicate using ‘N/A’ in ALL fields for this contact.Sales Contact* Name Telephone Number Fax Number Email This field is required. If you do not have a Sales Contact, please indicate using ‘N/A’ in ALL fields for this contact.Purchase Order Contact* Name Telephone Number Fax Number Email This field is required. If you do not have a Purchase Order Contact, please indicate using ‘N/A’ in ALL fields for this contact.Accounts Contact* Name Telephone Number Fax Number Email This field is required. If you do not have an Accounts Contact, please indicate using ‘N/A’ in ALL fields for this contact.Email for Remittance Advice* Price List Valid Until* DD slash MM slash YYYY Discount Off Trade List Price*Minimum Order Value Exc. VAT*Minimum Carriage Paid Order Exc. VAT*Carriage Charge if Below Minimum*Prices supplied to Virginia Hayward Ltd are confidential and must not be discussed with any other customersMinimum 6 months shelf life on all products?*YesNoLead time for orders?*PAYMENT TERMS: 25th of the month following requested delivery date.Signature*Please enter your name to electronically sign this documentPosition*Date DD slash MM slash YYYY EmailThis field is for validation purposes and should be left unchanged.
