CLIENT INITIALIZATION New Client Form

This form is to be completed when a myShipINFO or CAN contract has been signed. The purpose of this form is to obtain the necessary client information in order for the client to be setup. You are required to fill this form out completely. Please copy, Ashley Bell, Tricia Stitz, John Stitz, Dan Coppersmith, Mike Chappell and Deb Boothman

Sales Rep: / Deb Boothman
Account Manager / Deb Boothman

Client Name: Company Name Client Code: HOWA Hourly Billing Rate: N/A

Howard Berger (If Applicable)

Project Type (Check all that apply)

FAP-Parcel FAP-NSP Bill Payment G/L Coding

CAN-Parcel CAN-NSP

CAN-Data Analytics (Hourly) CAN-Data Analytics (Fixed Fee)

Customer Type Billable Customer Proof of Concept (do not file)

Trial (file for credits, but do not bill customer) for _____ weeks

Service Agreement Execution Date: 3/29/2012 NDA Execution Date: 3/29/2012

Client Contact Info: Send Invoice to: AP Contact

Name: / Ted Haldis / Name: / Ted Haldis
Contact: / Contact:
Title: / VP of Ops / Title: / VP Ops
Address: / 324 A Half Acre Road / Address: / 324 A Half Acre Road
Cranbury NJ 08512 / Cranbury NJ, 08512
Phone No: / 609-860-9935 / Phone No: / 609-860-9935
Fax No: / Fax No:
Email Address / / Email Address /

Project Description: (Description will appear on invoice code)

Notes:


Invoice Amount:

The following information will be used when invoicing the customer for the purchase of myShipINFO services.

FAP Service Fee:
Contingency Fee
FAP Monthly Flat Fee / $
Transaction Fee: / $
FAP Parcel / $ .06 per unique tracking number
FAP LTL/FTL (EDI) / $
FAP LTL/FTL (Paper) / $
FAP Ocean (EDI) / $
FAP Ocean (Paper) / $
CAN Service Fee:
CAN Parcel
CAN Parcel (Fixed Fee) / $
CAN LTL/FTL / % of Savings
CAN LTL/FTL (Fixed Fee) / $
CAN Ocean / % of Savings
CAN Ocean (Fixed Fee) / $
Notes:

Payment Terms:

Net 15 days (15 Days is standard)

Expenses: Bill to Client Do Not Bill

Notes: / 500.00 set up fee for G/L coding


Carrier Support:

UPS FedEx DHL LTL/Common Carrier Ocean Other

Notes:

Carrier Agreement Setup:

Carrier Agreement(s) on file: / Yes No NA
Late Pick-up Time: / Yes No
Close Invoice Using: / Transaction Count (UPS) Closed Count (FedEx)
UPS “Waived” GSR Filing - Ground / Yes No On some shippers (see notes)
UPS “Waived” GSR Filing - Express / Yes No On some shippers (see notes)
FedEx “Ground” GSR Waiver: / Yes No On some shippers (see notes)
FedEx “Express” GSR Waiver: / Yes No On some shippers (see notes)
Client has enabled Signature Tracking (UPS) / Yes No
Notes:

Electronic Invoice Setup:

UPS Flat File
/ Yes No NA
Links will be sent to
Customer will email files
enVista to download from ups.com
User Id: Password:
FedEx EDI 250 / Yes No NA
FedEx On-Line Billing / Yes No NA
FedEx Direct Link / Yes No NA
LTL (Specify Carrier Name) / Yes No NA
Ocean (Specify Carrier Name) / Yes No NA
Notes:


Shipper Account Setup:

Shipper Account #’s:
(Include Shipper Acct. # and Address Information) / Carrier Setup Fee / Carrier
00007A9V04 HOWARD BERGER COMPANY INC.
324 HALF ACRE RD
CRANBURY, NJ 08512
02
0000901344 GREAT AMERICAN MARKETING
29145 THE OLD RD
VALENCIA, CA 91355
02
24272F – 1777 Hylton Road, Pennsauken, NJ 08110-1315
324A Cranbury Half Acre Rd, Cranbury, NJ 08512 / $

For Internal Team Use

Date Received/Received By: / Date Entered into System
Date of Initial Client Setup / Customer Code

Last Revised: 1/01/2010 11/5/2012