USE New Customer - Accounting & Fulfillment Information

New Customer Application

Inventory, Purchasing & Fulfillment
Individual Filling Out Form Name*

First NameLast Name
Individual Filling Out Form Email*
example@example.com
Company Legal Name*
Accounting Information
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Accounts Payable Contact*

First NameLast Name
AP Email*
example@example.com
AP Phone Number*
Please enter a valid phone number.
Accounts Receivable/Trade Spend Contact

First NameLast Name
AR/Trade Spend Email
example@example.com
AR/Trade Spend Phone Number
Please enter a valid phone number.
Remittance Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Fulfillment Information
Primary Ship To Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Address Ship To Code - (GLN)
Purchasing Contact*

First NameLast Name
Purchasing Contact Phone Number*
Please enter a valid phone number.
Purchasing Contact Email*
example@example.com
Receiving Contact - The Person that sets delivery appointments*

First NameLast Name
Receiving Contact Phone Number*
Please enter a valid phone number.
Receiving Contact Email*
example@example.com
Delivery/Receiving Hours*
Delivery Hours & Special Delivery Instructions - Lumper, Liftgate, Limitation on truck size etc.
None
PREFERRED PALLET TYPE?

GMACHEP
Do you have multiple ship to addresses?*

YesNo
Ship To Address #2*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address 2 Ship To Code - (GLN/DUNS/DUNS+4)
Ship To Address #2 Purchasing Contact*

First NameLast Name
Ship To Address #2 Purchasing Contact Phone Number*
Please enter a valid phone number.
Ship To Address #2 Purchasing Contact Email*
example@example.com
Ship To Address #2 Receiving Contact*

First NameLast Name
Ship To Address #2 Receiving Contact Phone Number*
Please enter a valid phone number.
Ship To Address #2 Receiving Contact Email*
example@example.com
Do you have more than 2 ship to addresses?*

YesNo
Ship To Address #3*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address 3 Ship To Code - (GLN/DUNS/DUNS+4)
Ship To Address #3 Purchasing Contact*

First NameLast Name
Ship To Address #3 Purchasing Contact Phone Number*
Please enter a valid phone number.
Ship To Address #3 Purchasing Contact Email*
example@example.com
Ship To Address #3 Receiving Contact*

First NameLast Name
Ship To Address #3 Receiving Contact Phone Number*
Please enter a valid phone number.
Ship To Address #3 Receiving Contact Email*
example@example.com
Will the customer order through the poppi Portal or EDI?

poppi PortalEDI
Order by Pallet Info

11 pallet minimum per order * 22 pallet max per order * 12PKs = 180 cases/pallet * 12PK 16OZ = 140 cases/pallet * 4PKs (1 tray = six 4PKs) 90 trays/pallet * 540 4PKs/pallet 8PKs (1 tray = three 8PKS) 100 trays /Pallet 300 8PKs/pallet
INITIAL ORDER SKU'S

50001 WATERMELON 12PK50003 ORANGE 12PK50005 GINGER LIME 12PK50006 STRAWBERRY LEMON 12PK50007 RASPBERRY ROSE 12PK50010 CLASSIC COLA 12PK50011 ROOT BEER 12PK50012 DOC POP 12PK50013 CHERRY LIMEADE 12PK50017 GRAPE 12PK50019 LEMON LIME 12PK50023 ORANGE CREAM 12PK50024 CHERRY COLA 12PK50026 WILD BERRY 12PK50601 STRAWBERRY LEMON 12PK 16OZ50602 ORANGE 12PK 16OZ50603 LEMON LIME 12PK 16OZ50604 WILD BERRY 12PK 16OZ51018 FRUIT VARIETY 8PK51019 CLASSICS VARIETY 8PK40003 ORANGE 4PK40006 STRAWBERRY LEMON 4PK40007 RASPBERRY ROSE 4PK40008 CHERRY LIMEADE 4PK40010 COLA 4PK40011 DOC POP 4PK40012 ROOT BEER 4PK40013 LEMON LIME 4PK40014 GRAPE 4PK
Should be Empty:

New Customer Application

Accounting Information

Fulfillment Information

Order by Pallet Info