CINMAR LABELING SERVICE ORDER FORM

Fax to: ELMICRON Printing Services: + 49 (0) 3445 770142

Please fill out all information in accordance with the “Cinmar Vendor Relations Manual”. This form is designed to ensure the appropriate information is included on each case or item label sent to Cinmar. Please note, the “*” next to a field indicates that this field can be added by hand at a later date. This is to allow you to order labels in advance of your shipment for your convenience.

FROM: (your company) TO: (shipping location)

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Phone: (_____) ______- ______

Fax: (_____) ______- ______

Contact Name: ______

Quantity of each label type (1 type per form): Case Label: _ _ _ _ _ or Item Label: _ _ _ _ _

*TRUCK LINE/CARRIER: ______

*PRO # (if available): ______

*BILL OF LADING # (if available): ______

*PURCHASE ORDER #: ______

*CINMAR ITEM #: ______

*VENDOR ITEM #: ______

*SIZE (if applicable): ______

*COLOR (if applicable): ______

*PRODUCT DESCRIPTION: ______

*NUMBER OF CASES IN SHIPMENT: ______

*QUANTITY PER CASE: ______

BAR CODE INFORMATION - MANDATORY:

YOUR VENDOR UCC/EAN # (first 7 digit of your UCC/EAN Article Code) ______(if not AIN below)

REQUESTED SERIALIZED START # ______

Please check here if an Alternative ID Number (AIN ) is to be used in lieu of UCC number _____

“AIN” Number registration charge is € 50.00 (one time fee) assigned in place of UCC Vendor Number

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An expedite fee of €10.00 is charged for standard parcel service. Also, for faster delivery you may request overnight shipment method which will be charged according to service ( European regions typically € 95,-). Otherwise, all orders will meet your requested delivery date, and typically ship within two business days.

Orders will be handled with first in - first out processing.

Price calculation

Printing Service charge per order € 20,-

Setting charge per label content or change ea. € 5,-

Label print incl. material ea. € 0,12

Expedition fee € 10,-

optional on request:

Overnight Parcel or Document Service: according to service

Note: Prices are calculated in EURO (€) and do not include tax

Your requested delivery date for the labels: _ _ / _ _ / _ _

Date, Name, Signature: ......

*Case labels are not combinable with other labels. Changes in label information start a new order.