General Information:

(REQUIRED TO PROCESS REBATES)

Contact Information:

Supplier Information:

DIRECT MANUFACTURER AGREEMENTS:
If you or any entity on your behalf has established direct manufacturer agreements for your operation and desires to remain on those programs, you must list them on page (2) in order to inform those manufacturers of your intention to remain a direct-contracted party. Failure to disclose this information will acknowledge that you agree to participate in the Foodservice Restaurant Partners Group FL LLC program with all manufacturers not disclosed. You also agree to update Foodservice Restaurant Partners Group FL LLC of any additions/deletions to the program below:

ACKNOWLEDGEMENT AND AUTHORIZATION (Acceptance required)

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 with Foodservice Restaurant Partners Group FL LLC and, to the best of my knowledge, all information provided is correct. If Foodservice Restaurant Partners Group FL LLC should discover that the information provided is not correct, Foodservice Restaurant Partners Group FL LLC has the right to cancel or amend our participation in any and all programs. Foodservice Restaurant Partners Group FL LLC will not issue checks to member if the amount is less than Fifty dollars ($50.00). PLEASE NOTE: : Your first Rebate check may arrive up to 9 months after we begin to receive purchasing data, and then semi-annually thereafter if minimum purchasing requirements are met. If minimum requirements are not met, checks will arrive annually.

I acknowledge that any current programs we desire to continue through a direct relationship have been disclosed, and I understand that we will not be allowed to participate in the Foodservice Restaurant Partners Group FL LLC program as it pertains to those manufacturers. Further, if it is discovered that a program exists that was not disclosed above, we authorize FRPG to allow us to remain on the FRPG program and will cancel said direct agreements within Five (5) business days. I agree that in the event of non-disclosure of any direct manufacturer programs that result in a ‘double-dip’ situation, reconciliation may occur.

By signing this form, I authorize the above distributor(s) to provide regular, timely reporting of purchase transaction data for our locations to Foodservice Restaurant Partners Group FL LLC for the purpose of price deviations, rebate tracking and volume allowance opportunity analysis. I understand that at times, Foodservice Restaurant Partners Group FL LLC may engage third party processors in order to maximize my rebates and savings I agree to and acknowledge that Foodservice Restaurant Partners Group FL LLC will receive financial consideration for the administration of this program from certain program providers based on my participation.

I hereby agree on my own behalf and/or as an authorized agent of member, to hold Alpha Links, its affiliates, and their respective successors and assigns harmless from any and all claims, suits, causes of action, which may be asserted against them and any judgments, damages, or losses arising either directly or indirectly from my membership in Foodservice Restaurant Partners Group FL LLC and/or receipt of benefits as a member thereof. Termination of membership will be effective upon thirty (90) days’ written noticed from member. All rebates will expire as of the written notice date.