THE KROGER CO. STANDARD VENDOR AGREEMENT FOR ...

THE KROGER CO.
STANDARD VENDOR AGREEMENT FOR MERCHANDISE (PRODUCTS)
VERSION JANUARY 2011
SIGNATURE PAGE
The signature set forth below acknowledges Vendor’s agreement with and acceptance of the Standard Vendor
Agreement for Merchandise (Products) – Version January 2011.
Vendor (legal entity name):
Business Entity Type (e.g., Corp., LLC, etc.):
Vendor Name as Shown on Invoice (DBA):
Vendor Taxpayer Identification Number (EIN/SSN):
Kroger Vendor Number:
Vendor Contact Name/Title:
Vendor Contact Address: Street / Suite:
City / St / Zip:
Vendor Contact #s: Phone: Fax:
Vendor Emergency Contact Name/Title:
Cell: E-Mail:
Vendor Emergency Contact Address: Street / Suite:
City / St / Zip:
Vendor Emergency Contact #s: Phone: Fax:
Name of Signatory/Title:
Cell: E-Mail:
Signatory Signature: Date Signed
Kroger Representative Contact Name/Title:
Kroger Representative Contact Address: Street / Suite:
City / St / Zip:
Kroger Representative Contact #s: Phone: Fax:
Please check the appropriate statement below:
Cell: E-Mail:
� Vendor has read and agrees to comply with this Agreement.
� Vendor has read and agrees to comply with the terms of this Agreement as amended by Vendor’s proposed changes
attached to this Signature Page in the form of an amendment. Vendor understands that no addendum or amendment
to this Agreement will go into effect until signed by Vendor and an authorized representative of Kroger. Vendor’s
shipment of Products subsequent to the date of its receipt of this Agreement will be deemed to be acceptance by
Vendor of this Agreement, without modification, unless Kroger has executed an addendum attached to this Signature
Page.
PLEASE RETURN THIS COMPLETED SIGNATURE PAGE TO YOUR KROGER REPRESENTATIVE AND RETAIN
A COPY FOR YOUR RECORDS.
FAILURE TO CHECK EITHER BOX ABOVE WILL BE DEEMED TO BE ACCEPTANCE BY VENDOR OF THIS
AGREEMENT WITHOUT MODIFICATION.
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