Industrial Supply Solutions, Inc.

Request For Vendor Number

Vendor Name
Address Line 1
Address Line 2
Address Line 3
City
State
Zip
Account Number
Contact
Freight Paid Amount
Minimum Purchase Amount
Small Order Charge
Suggested Buyer:

Note:  If this is going to be one of 

The vendors that you want purchasing 

to place the orders, please suggest a buyer !

The options are:

Buyer # Name
200 Hugh Wilhelm
122 Robert Bickley
157 Roger Nichols
299 Steve Robinette
888 Non-Stock

Please contact the suggested buyer to discuss 

this Vendor! 

Please Type in the Buyer # Below

Vendor Phone #
Vendor Fax #  
Requested By
Email address