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CSA Request Form
Today's Date
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This is for EXISTING CUSTOMER who would like savings on GPO. This form will trigger our back office to create a CSA for a prospective customer to help you close the deal. Please collect as much vendor invoice data as you can prior to submitting this form so that everything can be loaded at one time. It is better to show maximum savings on a CSA from 4+ vendors, rather than partial savings CSA, so we'd rather wait to submit a stronger proposal, as opposed to sending them 1-2 savings quotes at a time while we're waiting for others.
Master Agent
9416-8499 Quebec INC
Aaron Holt
Adaptive Network Solutions LLC
Anicha.net
Asset Protection - Jeffery Moore
Audrey Roland
Banyan Connex LLC
Berg
Bella A. Maslyak
Beverly Grant
Beyond Grey Skies, LLC
BigChair Media
Bloomrock Partners
Blue Pride IS
Brandon Carroll
Business Excellence Strategies LLC
Cable Contract Negotiation Group, LLC
Canada LTD
CANDID Solutions, Inc.
CCR Solutions, LLC
Chris Kent
Cornerstone Logistics Alliance
Cost Management Associates, LLC
David Delk
D&C Marketing Associates
Dennis Frosolone
Domingo Serrano
Doubleday Group, LLC
Dreambly, LLC
Eduard Martinez
Eiger Creative LLC
Empower Impact Solutions
Expense to Profit, LLC
F&B Client Group LLC
Financial Problem Solvers, Inc
First Payment International Inc.
Florida Graphics Alliance
Franklin Rivera
Global Connect Communications LLC
Home Wire 1 Digital Connex Inc.
Impact Solution Pro
Iuliana Dediu
Jason Snodgrass
Jeremy Robinson
Jesús Gutiérrez
John Knettles
John Murphy
Jon Massad and Management Resources
JPR Investments
Lauren Segal
Leyton
LSI ADVISORY GROUP LLC
Mark Linden
Mark Strittmatter
Mass Enterprises LLC - Jason Mass
Merchant Cost Consulting, LLC
Merchants United
Merit Group International Inc.
Mitchell Ulman
MLN Elevation, LLC DBA Optimally
Mrs. Nguyen
MWaste, Inc. - Keeth Kipp
Muhammad Qasim Raza (Faheem's Sub-Agent)
O'Connell Consulting LLC
Operations X - Preston Weekes
Penny Yoder
PerkPlans LLC
PKPK Inc.
Rampwise, LLC
Randy Ulman
Ray Soriano
Rick Crawford Enterprises
Sanguine Strategic Advisors LLC
S and L Telecom LLC
Sean Cook
Seapoint Technologies LLC
Seattle Line Communications, Inc.
Shipment Trackers
Small Business Is MY Business LLC
Spot2020LLC
StoneHorse Enterprises
Synergize Bix LLC
Thad Leingang
The CFO Solution LLC
Touchtone Communications, Inc DBA: Premier Communications
Viva Concepts LLC
VLH Services
YSS LLC Your Supplemental Staff
Zephyr DeWitt LLC
My agency agreement hasn't been processed yet
Referring Agent's Name
Prospect's Company Name
Prospect's Contact Person
Prospect's Email Address
Prospect's Phone Number
Data you are uploading for the CSA
Comcast or Xfinity
DIRECTV
Spectrum
Cox
CenturyLink
AT@T
Dish TV
T-Mobile
Allstream
Telecom (COAX)
Telecom (FIBER)
Cellular for Phone
Utilities (Gas)
Utilities (Electric)
Worker's Compensation Insurance
Health Insurance
Property Insurance
Car Insurance
Credit Card Processing
Office Supplies
Durable Medical Equipment
Waste Management (Standard Waste)
Waste Management (Medical Waste)
Paper Shredding
Food
Beer - Alcohol - Wine
Produce
Alarm System
FedEx
UPS
DHL
Medline
McKesson
Dishwasher-Chemicals-Linens
Eco Lab
Farmer Brothers
Pepsi
Coke
Car Rentals
Air Travel
Home Depot
Uniforms
Enter verified vendor data here if you don't
have bill copies
Other Telecom Provider
DRAG AND DROP ALL YOUR BILLS HERE!
You Want Savings, We Want Your Bills!
The More Bills, The More Savings.