PRIME VENDOR FOODSERVICE OPERATING SUPPLIES LSN 
                                                                                                                                                                                    REQUEST FORM
                                                                                         NEW ITEM REQUEST FOR APPROVAL & AUTHORIZATION 832 CATALOG UPDATE
                                                                                  PLEASE PROVIDE THE FOLLOWING APPLICABLE INFORMATION AND ANY OTHER PERTINENT INFORMATION
                                                               STOCK NUMBER CURRENTLY EXISTS
                                                               REQUEST FOR NEW STOCK NUMBER
                                                      ITEM NAME
                                                      DESCRIPTION
                                                      MANUFACTURER SKU #                                                                                                                                                          COUNTRY OF ORIGIN
                                                                                                               PAPER                        PLASTIC STAINLESS STEAL
                                                      ITEM MATERIAL                                                                                                                                                  GLASS RUBBERCLOTH ALUMINUM WOODENSTYROFOAM
                                                      TYPE OF CONTAINER                                                 BOTTLE PAIL                                   BOX BAG AERSOL PUMP-SPRAY OTHER (Please Specifiy):
                                                      IS CONTAINER OR PACKAGE                                                                                 BIODEGRADABLE                                          YES                     NO                                     RECYCLABLE                                  YES                    NO
                                                      IS PACKING MATERIAL                                                                                    BIODEGRADABLE                                           YES                     NO                                     RECYCLABLE                                  YES                    NO
                                                      DIMENSIONS( Length, Width, Height, Diameter )
                                                      COLOR
                                                      STYLE
                                                      SIZE
                                                                                         SQUARE ROUND OBLONG OVAL                                                                                                                                    OTHER (Please Specifiy):
                                                      SHAPE                                                                                                                                             RECTANGULAR
                                                      UNITS PER CASE                                                                                                                                          UNIT OF ISSUE                                      EACH (EA) CASE (CS)
                                                      ITEM WEIGHT
                                                      BRAND NAME
                                                      MANUFACTURER NAME
                                                      MANUFACTURER'S WEBSITE
                                                      MANUFACTURER ITEM NUMBER
                                                      PRIME VENDOR NAME & PART NUMBER
                                                      CUSTOMER / INSTALLATION NAME/POC
                                                      CUSTOMER POC PHONE NUMBER
                                                      COUNTRY OF ORIGIN
                                                      DSCP POINT OF CONTACT(NAME & PHONE NUMBER)
                                                      ADDITIONAL PRODUCT INFO
                                                        DELIVERED PRICE                                                                                                                                                              AS DOCUMENTED BY ATTACHED INVOICE/PRICE QUOTE
                                                        DISTRIBUTION CATEGORY                                                                                                                                                     DISTRIBUTION PRICE
                                                         UUUNNNIIITTT   PPPRRRIIICCCEEE   TTTOOO   BBBEEE      TTTRRRAAANNNSSSMMMIIITTTTTTEEEDDD                                                                                    TRANSPORTATION FEE
                                                          [        ]     ITEM IS HEREBY APPROVED AND AUTHORIZED TO BE ADDED TO THIS PRIME VENDOR CATALOG
                                                          [        ]     ITEM IS NOT APPROVED             REASON:
                                                         COORDINATION BETWEEN:
                                                              CUSTOMER                          NAME:                                                                                                                                                                                           DATE:
                                                              ACCOUNT MANAGER           NAME:                                                                                                                                                                                                   DATE:
                                                              ACQUISITION SPECIALIST   NAME:                                                                                                                                                                                                    DATE:
            SIGNATURE OF CONTRACTING OFFICER                   DATE