Please Check Applicable Box. ¨ I am purchasing ____________ shares of the Company’s common stock at a price of $11.50 per share, reflecting the fact that selling commissions and dealer manager fees will not be payable in connection with such purchase, as a participant in the Company’s directed share program. ¨ In connection with my rights as a member of ____________ (the “Fund”), I am purchasing ___________ shares of the Company’s common stock at a price of $12.04 per share, reflecting the fact that selling commissions will be 3.5%, and dealer manager fees will be 0.985%, of the gross proceeds from such sales, as a participant in the Company’s discounted share program. [Investor Signature] Acknowledged and agreed to as of the date first written above: AMERICAN REALTY CAPITAL PROPERTIES, INC. By: Name: Title:
Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): X A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Distribution Channel Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller X Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Processing Contact Information Contact Person Xxxx Xxxxxxxx Title Director of Sales Company D&H Distributing Address 000 Xxxx Xxxxx City/State/Zip Harrisburg, PA 17112 Phone 000-000-0000 Email Xxxxxxxxx@xxxxx.xxx Pricing Information In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. Yes No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. Yes No Cooperatives List any other cooperative or state contracts currently held or in the process of securing. Cooperative/State Agency Discount Offered Expires Annual Sales Volume TAB 4 VENDOR PROFILE Please provide the following information about your company: • Company’s official registered name. D&H Distributing Company • Brief history of your company, including the year it was established. D&H Corporate Overview D&H Distributing, founded in 1918, has delivered innovation and excellence over the last 105 years as a leader in the North American distribution market, supporting many technology-led industries. Through its powerful culture of trust, as well as its combined private and employee ownership structure, D&H has delivered record-setting growth.
Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Distribution Channel Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Processing Contact Information Contact Person Title Company Address City/State/Zip Phone Email Xxxxxxxx Xxxxxxx Contract Specialist Sitmatic 0000 Xxxxxx Xxxxxx Fullerton, CA, 92833 (000) 000-0000 xxxxxxxxx@xxxxxxxx.xxx Pricing Information In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. Yes No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. Yes No Cooperatives List any other cooperative or state contracts currently held or in the process of securing. Cooperative/State Agency Discount Offered Expires Annual Sales Volume North Carolina State Contract 51% 6/2023 $80,000 South Carolina State Contract 51% 12/2024 $30,000 Pennsylvania State Contract 50% 4/2024 $30,000 Tab 4 - Vendor Profile
Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached):
Please Check Applicable Box. (If the 3rd box is checked, a detailed explanation of the names and convictions must be attached): A publicly held corporation; therefore, this reporting requirement is not applicable. Is not owned or operated by anyone who has been convicted of a felony. Is owned or operated by the following individual(s) who has/have been convicted of a felony Distribution Channel Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Processing Contact Information Contact Person Title Company Address City/State/Zip Phone Email Xxxxxxxx Xxxxxxx Contract Specialist Sitmatic 0000 Xxxxxx Xxxxxx Fullerton, CA, 92833 (000) 000-0000 xxxxxxxxx@xxxxxxxx.xxx Pricing Information In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. II SITMI\TIC" Tab 4 - Vendor Profile
Please Check Applicable Box. 🞏 A publically held corporation; therefore, this reporting requirement is not applicable. 🗷 Is not owned or operated by anyone who has been convicted of a felony. 🞏 Is owned or operated by the following individual(s) who has/have been convicted of a felony KPMG LLP (KPMG or firm) has not been convicted of a crime. To the best of our knowledge, no current partner, principal or employee of the firm has been charged with or convicted of a crime relating to the firm’s business or provision of services to clients. ⮚ If the 3rd box is checked, a detailed explanation of the names and convictions must be attached. Distribution Channel Which best describes your company’s position in the distribution channel: Manufacturer Direct Certified education/government reseller Authorized Distributor Manufacturer marketing through reseller Value-added reseller Other: Services Provider Processing Information Provide company contact information for the following: Sales Reports / Accounts Payable Contact Person: Xxxxxxx Xxxx Title: Manager Contracts, West Region Company: _KPMG LLP Address: 000 X. Xxxx Xxxxxx Xxxxx 0000 Xxxx: Xxx Xxxxxxx Xxxxx: Xxxxxxxxxx Zip: 90071 Phone: _ +000 000 0000 Email: xxxxx@XXXX.xxx Purchase Orders Contact Person: Xxxxxxx Xxxx Title: Manager Contracts, West Region Company: _KPMG LLP Address: 000 X. Xxxx Xxxxxx Xxxxx 0000 Xxxx: Xxx Xxxxxxx Xxxxx: Xxxxxxxxxx Zip: 90071 Phone: _ +000 000 0000 Email: xxxxx@XXXX.xxx Sales and Marketing Contact Person: _Xxxxx Xxxxxxx Title: _Managing Director, KPMG Healthcare and Government Solutions Company: _KPMG LLP Address: 000 Xxxxxxx Xxxx Xxxxx 0000 Xxxx: Xxxxxxxxxx Xxxxx: Xxxxxxxxxx Zip: 95814 Phone: _+0 000 000 0000 _ Email: _xxxxxxxxxxxx@XXXX.xxx Pricing Information In addition to the current typical unit pricing furnished herein, the Vendor agrees to offer all future product introductions at prices that are proportionate to Contract Pricing. If answer is no, attach a statement detailing how pricing for NCPA participants would be calculated for future product introductions. 🗷 Yes 🞏 No Pricing submitted includes the required NCPA administrative fee. The NCPA fee is calculated based on the invoice price to the customer. 🗷 Yes 🞏 No Vendor will provide additional discounts for purchase of a guaranteed quantity. 🗷 Yes 🞏 No Actual discount will be determined based on individual statements of work and appropriate services. Tab 4 – Vendor Profile Please provide the following information about your company: Company’...
