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PURCHASING
Enrollment Instructions:
1. Compete and sign Axis Participation Agreement.
2. Complete and sign Third Party Data Tracking form.
3. Complete location list with location name, address, Distributor/Supplier and
Distributor /Supplier account number.
(Note: list all primary and back-up distributors including paper/chemical suppliers)
4.
Fax to: +703-547-0354
(or scan and email to [email protected])
Once enrollment forms are received Axis will contact the distributor(s) I supplier(s) to implement
monthly reporting. Progress reports will be supplied and a full report generated when data is
transmitted: rebate amount, estimated annual rebate savings and contract pricing opportunity
(lower invoice costs).
We appreciate the opportunity. If you have any questions please contact us at: 703-310-7607
Warmest regards;
John C Krebs
President -Axis Purchasing, LLC
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Purcellville, Virginia
15860 Wenner Farm Lane
703-310-7607
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Axis Purchasing Participation Agreement
PURCHAS ING
This Agreement made and entered into this _1_th day of _ _ _~ 2015, between---- -- - - (Member) and Axis Purchasing lie, (Axis) 15860 Wenner Farm Lane, Purcellville, Virginia 20132.
Background
Axis Purchasing (Axis), LLC provides procurement and supply chain management services to the foodservice and
hospitality industry throughout the United States; and Axis intends to include Member in manufacturing agreements,
supplier programs, provide rebate tracking and contract pricing where available to Client. Axis may also introduce
Client to additional supply chain management solutions.
Agreements
1. Term. This Agreement shall begin on the date first written above and shall continue indefinitely and until either
party notifies the other that they desire to terminate the Agreement. The Agreement may be terminated by either
party at anytime by providing a written notice.
2. Compensation. Axis will be compensated on a 80/20 (80% Member, 20% Axis) share of manufacturer rebates.
Compensation covers all expenses of Axis except as may be mutually agreed in writing.
3. Group Purchasing Affiliation. Participation in more than one Group Purchasing Organization is prohibited. Prior
to engaging Axis Purchasing a termination of existing GPO Affiliation (if applicable} will require written notification on
company letterhead, with effective termination date, to existing GPO. Copy of termination letter must accompany
this participation agreement. Are you currently enrolled in a GPO? No: _X_ Yes: __
4. Direct Manufacturing Programs. If you directly or your distributor on your behalf have contracts with
manufacturers and desire to remain on those programs, list the contracts below to assure those manufacturers of
your intention to remain a direct contracted party for those programs. Failure to list those programs wi ll
acknowledge that you agree to participate in the Axis Purchasing programs with all Manufacturers not disclosed. You
also agree to update Axis Purchasing of any additions or deletions to the programs listed below.
Further, if Axis discovers that a program exists that was not disclosed, Member agrees and authorizes Axis that
Member wants to remain on the Axis program. Once notified Member will cancel said direct agreement within 5
business days and agree to repay any manufacture requested monies related to the undisclosed program(s).
Existing manufacturing agreements: (List agreements below or attach list to participation agreement )
5. Program Support. Client agrees to review and support Axis program manufacturers with alternative products
which are economically beneficial and meet intended use and quality requirements.
6. Confidential Information and Materials. Client and Axis agree that all information and materials concerning
data, processes, partnership programs and business operations are confidential and shall not be disclosed to any
other person or used in any way that would be detrimental to respective businesses.
I am an authorized agent, owner or employee of the above Business and acknowledge that I have the authority to
enter into a participation agreement and, to the best of my knowledge, all information provided is correct. If Axis
should discover that the information provided is not correct, Axis has the right to cancel or amend our participation
in any and all programs.
By:
(Signature )
Name:
Title:
Wenner Fe
'03-310-76
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John C Krebs
President -Axis Purchasing, LLC
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PURCHASING
Third Party Data Tracking Authorization to Release Data
Letter of Participation (LoP) Content Requirements
- - - - - - - - - - - - noted as "Customer'', authorizes [Axis Purchasing, LLC] noted as
"Provider", to collect transactional purchase data from their distributor partners. lt is understood that
such data will be utilized for reporting, analysis, and related activities in accordance with the performance
of value added services provided to Customer by Provider.
Customer represents that the relationship between it and its members or unit locations, including
franchisees if appropriate, entitles them to collect this data for Provider.
Provider agrees to maintain the confidentiality and integrity of the information released into its
possession using such information only for the value added services agreed to with the Customer.
Date References
LoP Agreement Date
Effective Date for Data Exchange
Termination Date of Data Exchange
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1 /201s
1 /2015
OPEN
"Customer" Authorization Signature and Contact Information
Contact Name
Signature
Title
Company Name
Address
City/State/Zip
Phone
Fax
eMail Address
"Provider" Contact Information
Contact Name
Signature
John C Krebs
Title
Company Name
President/CEO
Axis Purchasing
1560 Wenner Farm Lane
Purcellville, VA 20132
Address
City/State/Zip
Phone
Fax
eMail Address
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703-310-7607
703-547-0354
[email protected]
Axis Purchasing
Purcellville, Virginia
15860 Wenner Farm Lane
703-310-7607
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Location Template
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PURCHASING
Location
State
I ZIP
City
Address
Distributor Name
and Location
Account
Number
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Purcellville, Virginia
15860 Wenner Farm Lane
703-310-7607
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