eximbrickell

Exim Brickell Supplier Application

Please complete the Supplier Application form and the lead buyer for your industry will contact you with more information.

Are you currently supplying to Exim Brickell?      Yes    No

What material can you supply to Exim Brickell?   

Company Information

Company name *

Parent Company

Country

Phone number *
(incl. country code)

Web page Address
   

Contact Person

Name *

Title/Position

Phone number *
(incl. country code)

Fax

Email *

Comments
   

Other Information

In which region do you have manufacturing facilities?

Europe

North America

Africa

Eastern Europe

South America

Asia & Pacific
   

To which region do you supply:

Europe

North America

Africa

Eastern Europe

South America

Asia & Pacific
   

Certficates/Code held:

ISO 14001  Yes   No

ISO 14001  Yes   No
   
   

 

  
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