Vendor Set Up Form (DPG-000-73)

Sections 1-6 to be filled out by vendor.
Section 1
Vendor Name*
Vendor #

(Assigned by Accounting Dept.)
Phone #
Fax #
Duns #
Mailing Address*
Mailing Address Street Address*

Street Address
Mailing Address Address Line 2

Address Line 2
City*

City
Hidden
Mailing State
State*

State
State*
State
ZIP / Postal Code*

ZIP / Postal Code
Country*
Country
Remit to Address
Remit to Address
- Same as mailing address
Remit to Address Street Address

Street Address
Remit to Address Address Line 2

Address Line 2
City

City
Hidden
Remit to Address State
State*

State
State*
State
ZIP / Postal Code*

ZIP / Postal Code
Country*
Country
A/R Contact
A/R Email
A/R Phone
Type of Purchase
- Raw Materials
- Packaging
- Service / Repair
- Maint. Repair / Operations
- Other
Description of Goods/Services
Vendor Payment Terms
Sales Email
Sales Phone
Section 2

BILLING INFORMATION INSTRUCTIONS
Preferred method of invoicing is by PDF via e-mail to: DPGAccountsPayable@drugplastics.com Invoices should be one per purchase order, not multiple purchase orders on one invoice
Section 3

CREDIT CARD INFORMATION - PREFERRED FORM OF PAYMENT
Our preferred method of payment is Credit Card. We offer payment by credit card through Bank of America. DPG will sign you (the vendor) up. Bank of America will send you a welcome e-mail explaining the process. First payment will provide you with logon and password information to retrieve credit card information. Please contact to DPGAccountsPayable@drugplastics.com or call Bethany Petery @ 610-369-5368, or Kristi Cowger @ at 610-369-5196 if you have any questions.
Credit Card Payment
- Yes
- No
Section 4

ACH INFORMATION FOR DIRECT DEPOSIT PAYMENT - 2ND PREFERRED FORM OF PAYMENT
Bank Institution
Bank Routing #
Bank Account #
Remittance E-mail Address
Bank Account Type
- Checking
- Savings
Section 5
Check all that apply
Bussiness Size
- Large Business
- Small Business
No. of Employees
Minority Owned
- Minority-Owned
Choose one of below
Please Specify*
The Vendor may wish to review the definition for the above categories in the Federal Acquisition 19.7 or 52.21908 at www.acquisition.gov/far. Supplier may also refer to the Small Business Administrations website at www.sba.gov/size/, or contact your local SBA office. By offer submission, if the subcontractor is a small business concern in FAR 48 CFR Part 19, subcontractor verifies that its SAM profile is current, accurate, and complete as of the date of offer for the subcontract .
Section 6

Please Enter Your DPG/DPC Contact Below
DPG/DPC Contact*
Date*
MM slash DD slash YYYY
DPG/DPC Contact Email*
Section 7

DPG/DPC Approval Routing (3 approval necessary)
Hidden
Director/VP of Requesting Dept.
Hidden
Date
MM slash DD slash YYYY
Hidden
Director/VP of Purchasing
Hidden
Date
MM slash DD slash YYYY
Hidden
Controller/CFO
Hidden
Date
MM slash DD slash YYYY
Hidden
Accounts Payable
Hidden
Date
MM slash DD slash YYYY

Δ

1 Bottle Drive
P.O. Box 608
Boyertown, PA 19512

610-367-5000

info@DrugPlastics.com

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Employee Portal | Supplier Portal

Sections 1-6 to be filled out by vendor.

Section 1

Section 2

BILLING INFORMATION INSTRUCTIONS

Section 3

CREDIT CARD INFORMATION - PREFERRED FORM OF PAYMENT

Section 4

ACH INFORMATION FOR DIRECT DEPOSIT PAYMENT - 2ND PREFERRED FORM OF PAYMENT

Section 5

Section 6

Please Enter Your DPG/DPC Contact Below

Section 7

DPG/DPC Approval Routing (3 approval necessary)