Request for Account Addition or Change
Originator
Account Ownership
Date Submitted
(if different than Originator)
Type of Action Requested
New Distributor (complete sections: I, II, III, IV, V and VI)
New Direct Account/OEM (complete sections: I, II, III, IV, V and IX)
New Reseller Account (complete sections: I, II, III, IV, V and VI)
Expand Product Line Offering (complete sections: I and others as-applicable)
Decrease Product Line Offering (complete sections: I and others as-applicable)
Cancel Distributor (complete sections: I and VII)
Transfer a Direct Account to a Distributor (complete sections: I, V and VIII)
Other (
)
New or Affected Account
Account Name
Bill-To Address: Street
City
State/Region
Country
Zip Code
Ship-To Address (if different)
Customer Number (if existing account)
Main Phone Number
Main Fax Number
Branch Locations
Key Contact (English name)
Key Contact (Chinese name, if applicable)
Phone / Email
Key Accounting Contact
Company Website
Justification / Action Plan
Why do you want to implement this
change?
What steps have you taken with this
account to initiative this change?
What additional steps will you take
with this account to implement this
change?
When do you expect this change to
be complete?
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CSF006 Rev 12.0
I.
Account Type
(choose one)
Distributor – Domestic
Direct – Europe
II.
Distributor – Europe
Direct – (all others)
Distributor (all others)
Catalog Distributor
Reseller
Direct – Domestic
One-Time Customer
Bill-To Party
Marketing Information
Customer Classification (choose one)
Distributor
Direct OEM
Catalog Distributor
End Customer
Specialty Distributor
Contract Manufacturer
Reseller
Industry Code/Business Unit (choose one)
Industrial
III.
Bioprocessing
Chemical Handling / Packaging / Food
Sales Order Information
Sales District (drop-down)
Sales Group (drop-down)
Price List (chose one)
Federal ID or VAT # (enter #)
IV.
Medical
Select One
Select One
Dollar
Euro
Pricing Information
Pricing Group (chose one)
Distributor (Americas)
Catalog Distributor
Direct / OEM
Reseller
V.
Global Distributor – A (42% *)
Global Distributor – B (37% *)
Global Distributor – C (33% *)
* For core product lines
DQ PRO-Drum Mfg
Coffee / Beverage
Bio Distributor
One-Time Customer
ROW Independent
List Pricing
Sales and Distribution Information
Product Line Access (choose one)
All Products
Industrial only
Medical only
Bioprocessing only
Chem Handling only
Packaging only
DQ PRO only
Food & Bev only
Med & Bio
Ind & Chem
Ind & DQ
Bio & DQ
Chem & DQ
Pkg & DQ
Ind & Chem & DQ
All, less Bio
All, less DQ
All, less Med/Bio
Market Segment (choose one main segment)
B01-Bioprocessing
C01-Chem High Purity
C02-Chem Gen Purpose
F01-NSF Water Filtration
F02-NSF OCS Coffee
F03-NSF Other
P01-Flex Pkg Food
P02-Flex Pkg Chemical
P03-Rigid Pkg Food
P04-Rigid Pkg Chemical
M01-Support Surfaces
M02-Comp/Cold Ther.
M03-Biomedical Lab
M05-Patient Monitoring
M06-Sterilizers & Reproc
M07-Surgical
M08-Wound Drainage
M09-Dental
M10-Med Training
M11-Oxygen Systems
M12-Dialysis
M13-Med. Cooling Lines
M14-Medical Other
I01-Consumer OEM
I02-Liquid Cooling Elect
I03-Printing & Ink Mgmt
I04-Engine Sys/Fuel Cell
I05-Analytical Instrum.
I06-Hydration
I07-Ind. Dispensing
I08-Factory Automation
I09-Industrial Other
I10-Catalog
Secondary Market Segment Code and % of business (if known)
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CSF006 Rev 12.0
VI.
Add a New Account or Expand Market Coverage of an Existing Account
Potential CPC Sales Volume ($) / Time Period
Regional / Market Coverage
Regional / Market Coverage by Existing
Distribution
Distributor’s Ability to Meet Market Needs
Potential Customer Base
Current Corporate Sales ($)
# of Employees
# of Outside Salespeople
What, if any, Laws Apply to in the Case of
Canceling this Distributor?
Line Card Summary (provide attachment, if
necessary)
Have you added this account to CRM?
If adding a Market/Product Line, what is it?
** A new Distributor Agreement must be signed to include the additional market coverage **
VII.
Cancel a Distributor
What, if any, Laws Apply to Canceling this
Distributor?
Is the Distributor in Agreement with Plans for
Termination?
How will Existing End Customers have Access
to CPC Products?
How will Existing End Customers be Notified?
How will Open Orders be Handled, if any
Exist?
** Attach the revised zip code/lead distribution information for the affected territory **
VIII.
Transfer a Direct Account to a Distributor
Current Annual Sales ($)
Type of Business / Market
Value-Added Service to be Provided by the
Distributor
** After open invoices have been paid, block account in SAP/Oracle **
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CSF006 Rev 12.0
IX.
Add a New Direct Account
Potential Sales ($)
Potential Usage Volume (Part Number &
Quantity > 100,000)
Type of Business / Market
How this Account is a Market Leader in their
Segment?
Define any Global Aspects of the Account
and/or Market
Is this Account Currently Buying Colder
Already? If so, where?
If so, does any Comp Need to go to the
Distributor that was Selling to this Customer?
Value-Added Service to be Provided by CPC
that Cannot be Provided by a Distributor
Quality and/or Engineering Requirements to
be Provided by CPC that Cannot be Provided
by a Distributor
Define Pricing Requirements and/or
Sensitivity
Have you added this account to CRM?
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CSF006 Rev 12.0
Final Reviews
Account Name
Security Screen & Commentary
Mandatory MSR Visual Compliance Restricted Party Screening results will be sent to Sales and Marketing
Coordinator by Inside Sales or designate.
Commentary/Reviews will be solicited from the Account Development Committee:
 President
 VP Sales & Marketing
 Americas Sales Director
 European Sales Director
 Asia-Pacific Sales Director
 Inside Sales Manager
 BUMs (Bio, Chem/Pkg, Ind, Med)
Commentary is voluntary (not required), and will be captured and distributed via email to the Account Development
Committee.
Sales Directors will send reviews/comments to the entire Account Development Committee.
Other reviews will be sent only to Inside Sales Manager. If there are comments, however, it will be sent to the
entire Account Development Committee.
Management Approval (required)
Inside Sales Manager
Approve
Decline
(or designate)
Date
Comments
Designate Name
(if applicable)
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CSF006 Rev 12.0