Hard Copy Form

Appendix B - Wanted Materials
                                Listing Form
                                                 Office Use Only
                                                                                                                                       Code #___________

Submit one form per listing : Copy as many forms as needed.                                         Item ID #__________

Company Name:_____________________________________Date: ____________
Address:____________________________________________________________
City: _______________________________State:______Zip Code:___________
Type of Business:___________________________# of Employees_______ S.I.C. Code:______
Contact:___________________________ Title:_____________________________
Phone #: _____-_____-________ Ext. _____ ; Fax #:_____-_____- _________ ;
Toll Free #: 800- _____- _________; e-mail address: ________________________

Material Classification Code Number: __________ (select the one category Code Number from the
                                                                       list in Appendix A that best describes the materials you are listing)

Item / Material to be listed as Wanted: ___________________________________________
                                                      (generic name / main usable constituent)

Description:_________________________________________________________________

____________________________________________________________________________

(Provide detailed information as you wish to have it appear in the catalog listing: include information
                    such as condition, amount, sizes, packaging, contamination. Limit is 250 charactors).

Possible Processes that generate the material:_____________________________________
                                                                                            (optional).

Supply of Material / Item: o On-Going o One Time Need

Quantity Wanted:__________________Units (ea., lbs., tons, cu.yds.):______
                                    Desired Total Wgt._________o Wet, o Dry

Future Quantity Wanted:__________________ Units (ea., lbs., tons, cu.yds.):______
                                                        Frequency (wk.,mo.,qtr.)________________

Necessary Support Documentation: o Sample o Lab analysis o MSDS o Photo
                    o Equip. Specs o Manual

Materials to be at: o No Charge, o Price Negotible, o Price/Unit: $__.___/ ____

 

Release Agreement:

The undersigned acknowledges to having read and agree to the terms of the DISCLAIMER and furthermore agrees to release M2X and its staff, sponsors, directors and advisors from any claim, liability, obligation, or responsibility resulting from, pursuant to, or connected to the listing of materials or any other matter related to the Maine Materials Exchange.

Signature:____________________________________ Date_____________________

A completed copy of this form may be mailed to M2X at 93 Maqouit Dr. Freeport, Me. 04032 or Faxed to 207-865-6478

For Assistance completing this form or for other information, Call M2X @ 207-865-6621 or contact Support@M2X.com

 

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Copyright 2000 Maine Materials Exchange
Last modified: February 18, 2000