Supplier Registration Form PLEASE SUBMIT ALL COLAS to HLC@HONOLULU.GOV BEFORE SUBMITTING THIS SUPPLIER REGISTRATION FORM Company Name * DBA Company Address Address 1 Address 2 City State/Province Zip/Postal Code Country CONTACT INFORMATION Ordering Contact Name * First Name Last Name Email * Phone * (###) ### #### Financial Contact Name * First Name Last Name Email * Phone * (###) ### #### Alcohol License # * BANKING AND FINANCIAL INFORMATION Bank Name Routing # Checking # Federal Tax ID DUNS # Remittance Email Financial Online Payment Program If you utilize an online payment platform, please indicate which platform below. Preferred Method of Payment * ACH (OBC Preference) PAPER CHECK ALTERNATIVE ONLINE BANKING TOOL Payment Terms * All terms begin the day of the product shipment. Net 45 Net 60 Net 90 Net 120 Sampling & Bill Backs * 2% Discount Included on PO 50% Bill Backs Submitted Quarterly Negotiated Directly with OBC LOGISTICS INFORMATION Warehouse Address - Please include * Preferred Carrier If there is anything additional information or instructions you would like to add, please include the information below. Thank you for submitting your Supplier Registration Form. A member of the ‘Ohana Beverage Company Executive Managment Team will be reaching out shortly.Mahalo
