NEW DISTRIBUTOR EVALUATION FORM

EU VAT no. for EU companies / Company registration no.
(Attach the registration certificate / proof to this form)

...

Name & Address

Contact persons

Company owner name:

Sels rep. name:

Name:

Mobile:

E-mail:

Website:

Size of the company (please convert to EUR)

Number of employees:

Turnover last year:

Profit last year:

Turnover year before:

Profit year before:

Do you carry any business with In Vitro Fertility (IVF) Laboratories?

1. Do you carry any business with In Vitro Fertility (IVF) Laboratories?

2. Does your company have a QMS (Quality Management System) implemented? If so, which standard(s) are you following? E.g. ISO, cGMP, FDA etc.

3. Does your company have a traceability system implemented - are you able to track the product to the end user in case of a recall?

4. Which IVF products do you currently carry in your portfolio? Specify the brand and type of product.

5. Which of these products are distributed on an EXCLUSIVE BASIS and which are distributed on a NON-EXCLUSIVE BASIS?

6. What is your current position in the market in your country in terms of the IVF brands you are distributing?

7. Which Oosafe products are you interested in distributing?

8. Do you sell any products competing to our products (e.g. disinfectants, plasticware, inline filters, air cleaner, VOC meters, particle counters, etc.)? Please specify which ones. Our website to assist you: https://www.sparmed.dk/en/products/

9. How many IVF Clinics are in your country? How many of them are you working with?

10. How many IVF Cycles (IVF trials) are done approximately in your country / year?

11. How did you find out about SparMED (e.g. via internet, exhibitions, etc.)?

12. Do you know any of SparMED’s products / have worked with them before?
Please specify which ones.

13. Have any of your customers ever used SparMED’s products before?

14. What do you expect from SparMED in terms of a potential collaboration?

15. How can a potential collaboration with your company benefit SparMED?

Preferred territory(-ies) to distribute SparMED’s products

Main competitors within the territory:

Forecast

Product:

Expected sale/year (in EUR):

Total yearly turnover:

Thank you for showing interest in becoming SparMED distributor.

Your application will be evaluated, and feedback will be returned as soon as possible, regardless of if we will be able to offer you a collaboration agreement or not. Please be aware that as a distributor exclusive or non-exclusive you will have the privilege to distribute our products with competitive stable prices, but you will also have obligations to meet described in the contract. Moreover, your performance and cooperation will be evaluated yearly and if poorly performed, the distributor’s rights can be withdrawn.