Graybar Potential Manufacturer Questionnaire

Graybar purchases products for resale to other businesses. If you are interested in Graybar distributing your products, complete our Potential Manufacturer form and a Graybar representative will contact you.

Company Info

*Company Name

*Website (must begin with http://)

*Your Name

*Email

Phone Number ###-###-####

Address

City

State

Zip Code

Product Information

Choose your primary product offering

Description of Product

Disclosures

Is your company incorporated in the U.S.? Yes No

If yes, Date:

Total Years in Business

Are you fully prepared to disclose one of the following:

Last two years audited fiscal financial statements? Yes No

Last two years CPA prepared and reviewed fiscal financial statements, including an income statement, balance sheet, cash flow statements, and applicable notes? Yes No

Are you able to provide insurance Yes No

($5 million per occurrence for products/completed ops)?

D&B Number

US Point of Shipping Products:

Graybar Potential Manufacturer Questionnaire

Are you fully prepared to disclose one of the following:

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