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Price request + reservation request

Please complete this form. By sending this request, the Buyer submits an offer.
The Supplier may accept by written confirmation (email).

Language

English Nederlands Français Deutsch

Tip: fields marked “(auto)” are filled automatically where possible.

Supplier

Supplier name Supplier address Company number Send to (email) IBAN BIC

Customer

Company name Address Postal code and city VAT number Contact person Email

Product

Select product Product code / reference Product name Packaging Country of production Product text (auto by language) Requested price per kg (EUR)

€

Leave empty if you want the Supplier to propose a price.

Requested reserved quantity (kg) Product on call-off

Yes No

You wish to pay a 5% deposit for more certainty of delivery on the requested term

Yes No

If Yes: the deposit/compensation clauses and bank details are included in the email/copy/print.

Reservation date Delivery lead time (auto) Suggested target delivery date (auto) If earlier delivery is requested: earliest acceptable date (optional) Delivery location (optional) Remark (optional)

General terms (mandatory)

The email/copy/print will explicitly mention your acceptance and your request for a copy.