Supplier Scouting Request Form - Center for Industrial Research and Service

INSTRUCTIONS: Please fill out all relevant information to assist us in our search for the supplies/services you seek. The more information you provide will result in a more efficient and complete search. All information submitted is confidential.

NOTE: As a condition of engaging in CIRAS Supplier Scouting, companies agree to provide feedback to CIRAS on the success of the scouting efforts.

Company Name(Required)

County(Required)

Title(Required)

Email(Required)

Phone(Required)

Requested Scouting Location(Required)

Name of Item Being Sought(Required)

Item Description(Required)

Application(Required)

(How the item is used)

Materials and Manufacturing Process used (if known)

Summary of Technical and Performance Specifications(Required)

Volume Estimate(Required)

(Quantity and Frequency)

Target Price

Delivery Date Requirements

Quality/Certification Requirements(Required)

Current Suppliers of Good/Service

(This eliminates duplication of effort in identifying sources already in use.)

Additional Comments / Summary of Previous Research(Required)

Please provide a summary of the research you have conducted. This provides context on where we should begin our research to avoid duplication of effort. We want this information to be value-add for your company.

Potential Impact(Required)

Please consider what the business impact is in identifying a new/alternate source. For example, will it reduce production line shutdowns/delays; will it help generate new business growth, etc.

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Name

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