Supplier Onboarding Packet
Instructions & Guidelines
You must submit these documents as part of this process:
1) This Supplier Onboarding Packet, which contains forms and guidance common to all product categories and
departments.
2) You must also provide information specific to the product category. Follow the instructions under “Category-Specific Information”
and "Additional Product Claim Requirements" at http://supplier.wholefoodsmarket.com/
Your compliance with the three areas noted below will help expedite the supplier review and set-up processes.
1)
Please complete and sign the Supplier Onboarding Packet and all required Category-Specific documentation.
The Photograph and Video Release Form is optional to submit with the Onboarding Packet. However,
it is required if you wish to participate in any future marketing events.
2)
All forms may be signed electronically and returned via e-mail. If you prefer, documents can be printed, manually signed, and returned
by mail, facsimile, or hand-delivered to your Whole Foods Market business partner.
3)
As a new supplier you are required to provide a certificate of insurance as part of your application process. In order to simplify this
process for both Whole Foods Market and our suppliers, we have partnered with Ebix, Inc., an independent national services
company, to verify your insurance status. Please refer to the Insurance Instructions page for detailed instructions.
Exception: All produce suppliers must submit certificates of insurance in compliance with the produce supplier application process.
Version 2.3 / Dec 2015
Instructions for signing documents:
- If Supplier is an individual, sign individual name as the proprietor and give trade name, if any.
- If Supplier is a partnership, one general partner must sign in the partnership name.
- If Supplier is a corporation, an officer must sign and indicate title.
- The Supplier Agreement must be dated and the Supplier's address filled in.
Version 2.3 / Dec 2015
Supplier / Company Information
Supplier Status
Company d/b/a
or Other Business Names
Address City State Zip
County / Parish
Phone Fax Email
Address to remit payment to (if different from above):
Address City State Zip
PO Delivery Options
How would you like to receive PO's from WFM?
If Fax option selected, please provide Fax Number:
If E-Mail option selected, please provide PO e-mail address:
If E-Mail or Direct File Transmission selected, please select preferred file format:
Describe any shipping charges or order minimums; be specific please:
PO troubleshooting contact information (Customer Service):
Phone: Email
Supplier Production Facilities
Producing Facility (if different from above):
Name
Address City State Zip
Phone Fax Email
Product Information:
Please list product(s) intended to be sold to Whole Foods Market
Do you use a co-packer to produce above noted product(s)? If yes, please provide name & address:
As a food producer, has your product been registered with the FDA per the 2002 Bioterrorism Act?
If your facility falls under USDA, do you have regular USDA inspections? USDA Regist. #
Sales / Business Contact:
Please complete even if same as above
Name Title
Phone Fax Email
Accounting / Payment Contact:
Please complete even if same as above
Name Title
Phone Fax Email
Pref Payment Terms
If negotiated, name of approving WFM employee
Whole Foods utilizes a Direct Vendor Ordering System (DVO) that allows our stores to simply scan the products they wish to order, automatically generating PO's that are then
delivered electronically to our suppliers. The information in this section will allow WFM to tailor PO delivery to the needs of your business.
New Supplier
In
formation Update
Fax
Direct File Transmission (FTP)
E-mail
2%10Net30 Net45
Other Negotiated (specify)
N/A Yes No
Yes No N/A
HTML
TXT
XLS
XML
Updates are required whenever any supplier info. entered below changes
Franchise
Version 2.3 / Dec 2015
Whole
Foods Market Contact: (WFM Team Member with whom supplier is working to establish a business relationship
Name Title Dept
Do you have more than one cost base that would effect WFM? Are you a PACA vendor?
If yes, please explain:
Please Attach Copies of:
IMPORTANT: This Request Cannot be Processed Without the Attachment of All Relevant Documents!
1) Sample Invoice
2) Addresses/Phones of
any Distribution Facilities from which your Product will be Distributed
3) 3rd Party F
ood Safety Audit Inspection Certificate, if available
Name & Title of Person FROM SUPPLIER Authorized to Complete this Form:
Name Title Phone
Signature Date
Purchasing Team: Complete this Section and forward to Accounting
Delivery Options
(Please check all that apply)
Payment Terms
Team Name Date
Name (print or type) Job Title
Signature
Signed Supplier Agreement Received?
Product ingredients been reviewed against WFM Quality Standards?
IRMA Supplier Number
Accounting Team: Complete and Return Copy to Original Requestor
PS Supplier #: Approval Date W-9 Received?
Approver's Name
Approver's Signature
If no, reason
PACA is a USDA designation referring to certain suppliers with interstate or foreign
commerce in fresh and frozen fruits and vegetables.
Certificate of Insurance Received?
Sub-Team
Completed and signed EFT
Application Received?
FOR WHOLE FOODS MARKET USE ONLY
This Supplier Application and all agreements and documents required for supplier approval may be executed manually or electronically and shall become effective when manually executed or signature is
electronically inserted by typing the executing party’s name in the signature block below. If executed electronically, as further provided in the Texas Uniform Electronic Transactions Act (“UETA”) and the
Electronic Signatures in Global and National Commerce Act (collectively with UETA, “Applicable Electronic Signature Law”), the Supplier hereby voluntarily agrees to execute this agreement utilizing an
electronic signature and the words “executed,” “signed,” and “signature” shall be deemed to include electronic signatures. An electronic signature shall have full legal effect, validity and enforceability as an
manually executed original and the transmission of this signed Supplier Application and all required documents and agreements by facsimile, e-mail in “.pdf” form, or any other electronic means shall
constitute effective execution and delivery of this Supplier Application and all required agreements and documents.
May differ from term requested by supplier above. Payment
terms defined are in accordance with Global Payment Term
Policy and any state/federal laws.
Stores
Warehouses Commissaries
COD Supplier
No Yes
Yes No
Yes
No
Yes
No
Yes
No
Local Supplier
Yes No
Yes
No
Form
W-9
(Rev.
August 2013)
Department
of the Treasury
Internal
Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
Name (as shown on your income tax return)
Business name/disregarded entity name, if different from above
Check appropriate box for federal tax classification:
Individual/sole proprietor
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
▶
Other (see instructions)
▶
Exemptions (see instructions):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
Address (number, street, and apt. or suite no.)
Requester’s name and address (optional)
City, state, and ZIP code
List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
Social security number
–
–
Employer identification number
–
Part II
Certification
Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) t
hat I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding, and
3. I am a U.S. citizen or other U.S. person (defined below), and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign
Here
Signature of
U.S. person
▶
Date
▶
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS.gov for information
about Form W-9, at www.irs.gov/w9. Information about any future developments
affecting Form W-9 (such as legislation enacted after we release it) will be posted
on that page.
Purpose of Form
A person who is required to file an information return with the IRS must obtain your
correct taxpayer identification number (TIN) to report, for example, income paid to
you, payments made to you in settlement of payment card and third party network
transactions, real estate transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or contributions you made
to an IRA.
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the requester) and, when
applicable, to:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners’ share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct.
Note. If you are a U.S. person and a requester gives you a form other than Form
W-9 to request your TIN, you must use the requester’s form if it is substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a U.S.
person if you are:
•
An individual who is a U.S. citizen or U.S. resident alien,
•
A partnership, corporation, company, or association created or organized in the
United States or under the laws of the United States,
•
An estate (other than a foreign estate), or
•
A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or business in
the United States are generally required to pay a withholding tax under section
1446 on any foreign partners’ share of effectively connected taxable income from
such business. Further, in certain cases where a Form W-9 has not been received,
the rules under section 1446 require a partnership to presume that a partner is a
foreign person, and pay the section 1446 withholding tax. Therefore, if you are a
U.S. person that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your U.S. status
and avoid section 1446 withholding on your share of partnership income.
Cat. No. 10231X
Form
W-9 (Rev. 8-2013)
Page 2
Form W-9 (Rev. 8-2013)
In the cases below, the following person must give Form W-9 to the partnership
for purposes of establishing its U.S. status and avoiding withholding on its
allocable share of net income from the partnership conducting a trade or business
in the United States:
•
In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity,
•
In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust, and
•
In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax
on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident
alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a provision known as
a “saving clause.” Exceptions specified in the saving clause may permit an
exemption from tax to continue for certain types of income even after the payee
has otherwise become a U.S. resident alien for tax purposes.
If you are a U
.S. resident alien who is relying on an exception contained in the
saving clause of a tax treaty to claim an exemption from U.S. tax on certain types
of income, you must attach a statement to Form W-9 that specifies the following
five items:
1. The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the saving
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from tax.
5. Sufficient facts to justify the exemption from tax under the terms of the treaty
article.
Example. Article 20 of the U.S.-China income tax treaty allows an exemption
from tax for scholarship income received by a Chinese student temporarily present
in the United States. Under U.S. law, this student will become a resident alien for
tax purposes if his or her stay in the United States exceeds 5 calendar years.
However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30,
1984) allows the provisions of Article 20 to continue to apply even after the
Chinese student becomes a resident alien of the United States. A Chinese student
who qualifies for this exception (under paragraph 2 of the first protocol) and is
relying on this exception to claim an exemption from tax on his or her scholarship
or fellowship income would attach to Form W-9 a statement that includes the
information described above to support that exemption.
If you are a nonr
esident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
What is backup withholding? Persons making certain payments to you must
under certain conditions withhold and pay to the IRS a percentage of such
payments. This is called “backup withholding.” Payments that may be subject to
backup withholding include interest, tax-exempt interest, dividends, broker and
barter exchange transactions, rents, royalties, nonemployee pay, payments made
in settlement of payment card and third party network transactions, and certain
payments from fishing boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you receive if you
give the requester your correct TIN, make the proper certifications, and report all
your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding because you did
not r
eport all your interest and dividends on your tax return (for reportable interest
and dividends only), or
5. You do n
ot certify to the requester that you are not subject to backup
withholding under 4 above (for reportable interest and dividend accounts opened
after 1983 only).
Certain payees and payments are exempt from backup withholding. See Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships on page 1.
What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA)
requires a participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain payees are
exempt from FATCA reporting. See Exemption from FATCA reporting code on
page 3 and the Instructions for the Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you claimed to be
an exempt payee if you are no longer an exempt payee and anticipate receiving
reportable payments in the future from this person. For example, you may need to
provide updated information if you are a C corporation that elects to be an S
corporation, or if you no longer are tax exempt. In addition, you must furnish a new
Form W-9 if the name or TIN changes for the account, for example, if the grantor
of a grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
subject to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you make a
false statement with no reasonable basis that results in no backup withholding,
you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying certifications or
affirmations may subject you to criminal penalties including fines and/or
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,
the requester may be subject to civil and criminal penalties.
Specific Instructions
Name
If you are an individual, you must generally enter the name shown on your income
tax return. However, if you have changed your last name, for instance, due to
marriage without informing the Social Security Administration of the name change,
enter your first name, the last name shown on your social security card, and your
new last name.
If the account is in joint names, list first, and then circle, the name of the person
or entity whose number you entered in Part I of the form.
Sole proprietor. Enter your individual name as shown on your income tax return
on the “Name” line. You may enter your business, trade, or “doing business as
(DBA)” name on the “Business name/disregarded entity name” line.
Partnership, C Corporation, or S C
orporation. Enter the entity's name on the
“Name” line and any business, trade, or “doing business as (DBA) name” on the
“Business name/disregarded entity name” line.
Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as
an entity separate from its owner is treated as a “disregarded entity.” See
Regulation section 301.7701-2(c)(2)(iii). Enter the owner's name on the “Name”
line. The name of the entity entered on the “Name” line should never be a
disregarded entity. The name on the “Name” line must be the name shown on the
income tax return on which the income should be reported. For example, if a
foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes
has a single owner that is a U.S. person, the U.S. owner's name is required to be
provided on the “Name” line. If the direct owner of the entity is also a disregarded
entity, enter the first owner that is not disregarded for federal tax purposes. Enter
the disregarded entity's name on the “Business name/disregarded entity name”
line. If the owner of the disregarded entity is a foreign person, the owner must
complete an appropriate Form W-8 instead of a Form W-9. This is the case even if
the foreign person has a U.S. TIN.
Note. Check t
he appropriate box for the U.S. federal tax classification of the
person whose name is entered on the “Name” line (Individual/sole proprietor,
Partnership, C Corporation, S Corporation, Trust/estate).
Limited Liability Company (LLC). If the person identified on the “Name” line is an
LLC, check the “Limited liability company” box only and enter the appropriate
code for the U.S. federal tax classification in the space provided. If you are an LLC
that is treated as a partnership for U.S. federal tax purposes, enter “P” for
partnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to be
taxed as a corporation, enter “C” for C corporation or “S” for S corporation, as
appropriate. If you are an LLC that is disregarded as an entity separate from its
owner under Regulation section 301.7701-3 (except for employment and excise
tax), do not check the LLC box unless the owner of the LLC (required to be
identified on the “Name” line) is another LLC that is not disregarded for U.S.
federal tax purposes. If the LLC is disregarded as an entity separate from its
owner, enter the appropriate tax classification of the owner identified on the
“Name” line.
Other entities. Enter your business name as shown on required U.S. federal tax
documents on the “Name” line. This name should match the name shown on the
charter or other legal document creating the entity. You may enter any business,
trade, or DBA name on the “Business name/disregarded entity name” line.
Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
Exemptions box, any code(s) that may apply to you. See Exempt payee code and
Exemption from FATCA reporting code on page 3.
Page 3
Form W-9 (Rev. 8-2013)
Exempt payee code. Generally, individuals (including sole proprietors) are not
exempt from backup withholding. Corporations are exempt from backup
withholding for certain payments, such as interest and dividends. Corporations are
not exempt from backup withholding for payments made in settlement of payment
card or third party network transactions.
Note. If you are exempt from backup withholding, you should still complete this
form to avoid possible erroneous backup withholding.
The following codes identify payees that are exempt from backup withholding:
1—An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a possession of the United States, or any of
their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
States, the District of Columbia, or a possession of the United States
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
8—A real estate investment trust
9—A
n entity registered at all times during the tax year under the Investment
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—
A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section 4947
The following chart shows types of payments that may be exempt from backup
withholding. The chart applies to the exempt payees listed above, 1 through 13.
IF
the payment is for . . . THEN the payment is exempt for . . .
Interest
and dividend payments
All exempt payees except
for 7
Broker
transactions
Exempt payees 1 through 4 and 6
through 11 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of noncovered securities
acquired prior to 2012.
Barter
exchange transactions and
patronage
dividends
Exempt payees 1 through 4
Payments
over $600 required to be
reported
and direct sales over $5,000
1
Generally, exempt payees
1 through 5
2
Payments
made in settlement of
payment
card or third party network
transactions
Exempt payees 1 through 4
1
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2
However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys' fees, gross proceeds paid to an attorney, and payments for
services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify payees
that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, if you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
institution is subject to these requirements.
A—An organization exempt from tax under section 501(a) or any individual
retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a possession of the United States, or any
of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described in Reg. section 1.1472-1(c)(1)(i)
E—A c
orporation that is a member of the same expanded affiliated group as a
corporation described in Reg. section 1.1472-1(c)(1)(i)
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all times during the tax year under the Investment Company Act of
1940
I—A common trust fund as defined in section 584(a)
J—
A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
identification number (ITIN). Enter it in the social security number box. If you do not
have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or EIN. However, the IRS prefers that you use your SSN.
If you a
re a single-member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (or
EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is
classified as a corporation or partnership, enter the entity’s EIN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for an SSN, get Form SS-5, Application for a Social Security Card, from your local
Social Security Administration office or get this form online at www.ssa.gov. You
may also get this form by calling 1-800-772-1213. Use Form W-7, Application for
IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4,
Application for Employer Identification Number, to apply for an EIN. You can apply
for an EIN online by accessing the IRS website at www.irs.gov/businesses and
clicking on Employer Identification Number (EIN) under Starting a Business. You
can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-
TAX-FORM (1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
and write “Applied For” in the space for the TIN, sign and date the form, and give it
to the requester. For interest and dividend payments, and certain payments made
with respect to readily tradable instruments, generally you will have 60 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering “
Applied For” means that you have already applied for a TIN or that
you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or resident alien,
sign Form W-9. You may be requested to sign by the withholding agent even if
items 1, 4, or 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in Part I should sign
(when required). In the case of a disregarded entity, the person identified on the
“Name” line must sign. Exempt payees, see Exempt payee code earlier.
Signature requirements. Complete the certification as indicated in items 1
through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984
and broker accounts considered active during 1983. You must give your
correct TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts considered inactive during 1983. You must sign the
certification or backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TIN to the requester, you
must cross out item 2 in the certification before signing the form.
3. Real es
tate transactions. You must sign the certification. You may cross out
item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not have to sign
the certification unless you have been notified that you have previously given an
incorrect TIN. “Other payments” include payments made in the course of the
requester’s trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments made in
settlement of payment card and third party network transactions, payments to
certain fishing boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured
property, cancellation of debt, qualified tuition program payments (under
section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but you
do not have to sign the certification.
Page 4
Form W-9 (Rev. 8-2013)
For this type of account:
Give name and SSN of:
1. Individual
2. Two or more individuals (joint
account)
3. Custodian account of a minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulation section 1.671-4(b)(2)(i)(A))
The
individual
The actual owner of the account or,
if combined funds, the first
1
individual on the account
2
The minor
1
The grantor-trustee
1
The actual owner
3
The owner
The grantor*
For this type of account:
Give name and EIN of:
7. Disregarded entity not owned by an
individual
8. A valid trust, estate, or pension trust
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
charitable, educational, or other
tax-exempt organization
11. Partnership or multi-member LLC
12. A broker or registered nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a st
ate or local
government, school district, or
prison) that receives agricultural
program payments
14.
Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 F
iling Method 2 (see
Regulation section 1.671-4(b)(2)(i)(B))
The owner
4
Legal entity
The corporation
The organization
The partnership
The broker or nominee
The public entity
The trust
What Name and Number To Give the Requester
Note. If no name is circled when more than one name is listed, the number will be
considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal information such as your
name, social security number (SSN), or other identifying information, without your
permission, to commit fraud or other crimes. An identity thief may use your SSN to
get a job or may file a tax return using your SSN to receive a refund.
To reduce your risk:
•
Protect your SSN,
•
Ensure your employer is protecting your SSN, and
•
Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRS
notice or letter.
If your tax records are not currently affected by identity theft but you think you
are at risk due to a lost or stolen purse or wallet, questionable credit card activity
or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity the
ft who are experiencing economic harm or a system
problem, or are seeking help in resolving tax problems that have not been resolved
through normal channels, may be eligible for Taxpayer Advocate Service (TAS)
assistance. You can reach TAS by calling the TAS toll-free case intake line at
1-877-777-4778 or TTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails and websites. The most common act is sending an email to a user falsely
claiming to be an established legitimate enterprise in an attempt to scam the user
into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does
not request personal detailed information through email or ask taxpayers for the
PIN numbers, passwords, or similar secret access information for their credit card,
bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward this
message to phishing@irs.gov. You may also report misuse of the IRS name, logo,
or other IRS property to the Treasury Inspector General for Tax Administration at
1-800-366-4484. You can forward suspicious emails to the Federal Trade
Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or 1-877-
IDTHEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
1
List first and circle the name of the person whose number you furnish. If only one person on a
joint account has an SSN, that person’s number must be furnished.
2
Circle the minor’s name and furnish the minor’s SSN.
3
You must show your individual name and you may also enter your business or “DBA” name on
the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you
have one), but the IRS encourages you to use your SSN.
4
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the
personal representative or trustee unless the legal entity itself is not designated in the account
title.) Also see Special rules for partnerships on page 1.
*Note. Grantor also must provide a Form W-9 to trustee of trust.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with
the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation
of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS,
reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District
of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to
federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN
whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other
payments to a payee who does not give a TIN to the payer
. Certain penalties may also apply for providing false or fraudulent information.
Welc
ome!
As a new supplier you are required to provide evidence of insurance as part of your application. In order
to make this a simple process for you, we are partnered with Ebix, Inc., a web-based insurance services
company that collects electronic copies of Certificates of Insurance and verifies compliance to Whole
Foods’ insurance requirements.
Please follow these simple steps to create your company’s record in Ebix:
1. Enter the following address into your web browser or click on the link below:
https://www.ebixcerts.com/EBIXCOI/WFM/Login.aspx
Whole Foods Market Vendor Insurance Registration Link
2. You will be asked to create a username and password in order to access the site.
3. Provide your company’s information – name, address, contact information including email
address, and indicate the products or services your company provides to Whole Foods Market.
4. Enter your broker or insurance provider’s contact information.
The Ebix system will send you an email containing the Whole Foods Market insurance requirements
based on the risk level of your product or service and will provide instructions on how you or your
insurance provider electronically submits your Certificate of Insurance and Additional Insured
endorsement.
**Please note that Whole Foods Market Inc. is unable to process paper Certificates of
Insurance sent to our stores or offices via the postal service. Any Certificates of Insurance
received at a Whole Foods location through the U.S. Postal Service or by any other means
will not be processed or saved.
Ebix w
ill review your insurance documents for compliance and communicate with you further if there
are discrepancies that must be corrected. You will receive an email from Ebix when your insurance is
Compliant. You may access your Ebix record at any time by logging in with your username and
password.
Thank you for your cooperation and if you have questions or concerns, please contact Ebix Customer
Support at 951.766.2264.
Version 2.3 / Dec 2015
Version 2.3 / Dec 2015
Supplier Name
Supplier Number
Supplier Address
Supplier Phone/Fax
Supplier AR Contact Name
Supplier Contact E-Mail Address
Bank Name (US only)
Bank Address
Bank Phone
Bank Account #
Bank ID (ABA/Routing)
Account Type (Indicate with X)
Business Checking
Personal Checking
Personal Savings
Authorized Signature (Company Officer)
Date:
In compliance with local laws and NACHA Operating Rules, Whole Foods Market may initiate an entry (referred to as a Reversing Entry) to
correct an erroneous credit or debit previously initiated to the account denoted above. Per NACHA Operating Rules, a reversing entry must be
transmitted to the Receiving ACH Operator in such a time as to be transmitted or made available to the RDFI by midnight of the fifth banking day
following the Settlement Date of the erroneous entry. An erroneous entry is defined per NACHA Operating Rules as an entry that (1) is a duplicate
of an entry previously initiated; (2) orders payment to or from a Receiver not intended to be credited or debited; or (3) orders payment in a dollar
amount different than was intended by Payer. Whole Foods Market will notify the Receiver of the reversing entry and the reason for the reversing
entry no later than the Settlement Date of the reversing entry. The relationship of the parties hereto and all claims arising out of or related to that
relationship, including, but not limited to, the construction and interpretation of any written agreements, including this ACH Application Form, will
be governed by the substantive laws of the State of Texas (without regard to conflicts of law principles).
This ACH Application Form is performable and enforceable in Travis County, Texas. The parties agree and consent to the jurisdiction of the state
and federal courts located in Austin, Travis County, Texas and acknowledge that such courts are proper and convenient forums for the resolution
of any actions between the parties and agree that, in such case, these courts will be the sole and exclusive forums for the resolution of any
actions between the parties. Any signature delivered by electronic mail or facsimile will be treated for all purposes as an original.
Endeavoring to serve our suppliers and help the environment via paperless processing, Whole Foods Market is pleased
to offer electronic funds transfer (EFT) to our supplier community. It is our goal to make electronic payments our primary
method for generating payments. Please fill out and return the attached form at your earliest convenience to ensure
timely payment.
Among the benefits to participants in the EFT payment process:
1. No charge from WFM to the supplier
2. Payment transit directly to your bank account
EFT payments are processed daily (Mon-Fri and in accordance with related payment terms) for deposit to your bank
account the following day. The day prior to funding, we will submit an Excel spreadsheet to your preferred e-mail
address with detailed payment information.
3. Improved security
4. No lost checks
Requirements for EFT enrollment:
1. Valid US bank account
2. Single remit address per supplier
3. Valid e-mail address (presently only one email acct is possible)
4. Ability to accept Excel spreadsheets via email
Please complete the attached EFT vendor set-up form including signature and return to your WFM contact.
Attaching banking information on company letterhead will verify the request. This EFT form is also intended to
be used for related EFT payment information updates.
d/b/a
Version 2.3 / Dec 2015
Information for potential Suppliers regarding WFM's expectations for electronic
exchange of item catalogs, cost files, purchase orders, invoices and payments.
The following are WFM's expectations regarding electronic communication of information. WFM
is striving to reduce and where possible eliminate paper documentation and related exchanges.
To that end, we are continually enhancing our internal business systems to replace paper with
electronic documents. While this is still a work in progress, we believe the results will be mutually
beneficial to our suppliers and ourselves by streamlining the exchange of information between WFM
and our supplier community. If approved as a supplier, WFM will provide specific content and format
requirements and work with you to test and implement these communications.
Product Catalogs
WFM requires suppliers to upload product catalogs manually or via Excel spreadsheet through our
proprietary internet portal. Product catalogs must be maintained whenever changes occur and on a
regular schedule.
Cost Files
WFM requires suppliers to upload negotiated costs manually or via Excel spreadsheet through our
proprietary internet portal. Both regular and promotional costs must be provided. Costs must be
confirmed and/or updated through the internet portal on a regular schedule.
Purchase Orders
WFM prefers suppliers to be able to receive Purchase Orders sent electronically from WFM. WFM
has the ability to send PO's in a variety of ways including fax, email and direct files transmission.
WFM requires one invoice per PO and for WFM's PO number to be referenced on the supplier
invoice. WFM leverages various methods of communicating PO's including DVO and IRMA. Please
contact your WFM representative for additional information in these areas.
Invoices
Invoices must accompany all deliveries and must reference a PO number provided by WFM. Invoice
numbers must be numerical and unique. WFM encourages all suppliers to send invoices to us
electronically to streamline the cost validation and payment processes.
Payments
WFM offers Electronic Funds Transfer (EFT) to our suppliers at no charge. Suppliers who sign up for
this service will have payments made directly to their bank account and receive an email notification
of payment details preceding each electronic payment.
Version 2.3 / Dec 2015
In order to facilitate the process by which WFM collects information to prepare your items for ordering
and retail, we require each of our suppliers (vendors) to maintain item catalogs with complete and
accurate item information and timely cost information in our Vendor Internet Portal (VIP).
Properly maintaining your item catalog in VIP is necessary for:
· Communicating cost updates and margin management
· Creating accurate Purchase Orders
· Visibility of all available items
Before any item can be ordered, it must be presented and accepted by the appropriate buyer
and set up in our systems.
To start the VIP enrollment process, please provide the names and associated information for the
people in your company who will be responsible for providing and maintaining Cost Files for Whole
Foods Market through the VIP. Upon receipt, an onboard request for VIP will be initiated.
Company Name
First/Last Name Email Address Tel #
Primary Contact
Secondary Contact
The onboard request to VIP will be submitted to our national office and they will email the contacts
provided with instructions and information on how to create and maintain your VIP Cost File. They
will create an account for you in the VIP with usernames for the people you have listed above, and will
be available to answer any questions and guide you through the set up process.
Please note that cost file maintenance is a monthly requirement and the contact(s) provided
will be responsible for updating the cost file as needed every month or certifying that the cost
information has not changed. This will ensure accurate costs and also communicate to us that
the contact information for your company is still current.
Version 2.3 / Dec 2015
b) Use my name in connection with the recordings; and
I have read and fully understand the terms of this Consent and Release.
Name (Print)
Address
City State Zip
Phone
Signature Date
PARENT / GUARDIAN APPROVAL (if under 18):
Name (Print)
Signature Date
I hereby warrant that I am the parent and/or guardian of the individual minor named above, and have full authority to authorize the above
release which I have read and approved. I hereby release and agree to indemnify WHOLE FOODS MARKET and those acting pursuant to
their authority, from and against any liability arising out of the exercise of the rights granted herein.
For consideration which I acknowledge, I hereby give a direct or indirect subsidiary of Whole Foods Market, Inc. and its affiliated companies,
licensees, successors and assigns (collectively, “WHOLE FOODS MARKET”) and those acting pursuant to their authority, the right and
permission to:
a) Record my likeness and/or voice on a video, audio, photographic, digital, electronic or any other medium, and to edit
such recordings at WHOLE FOODS MARKET’s discretion;
c) Publish, reproduce, copyright, exhibit, display, distribute, and otherwise use the recordings, or any portion thereof, in all
forms and media including composite or modified representations for any lawful purpose that WHOLE FOODS MARKET, and
those acting pursuant to their authority, deem appropriate, including advertising, trade and any commercial purpose
throughout the world in perpetuity.
I understand and agree that all such recordings, in whatever medium, shall remain the property of WHOLE FOODS MARKET, and that they
may copyright material containing the recordings. I further understand and agree that no advertisement or other material need be submitted
to me for any further approval. I waive any right to inspect or approve the manner in which the recordings are used, or any printed matter
that might be used in connection with the recordings.
I release WHOLE FOODS MARKET and those acting pursuant to their authority from any and all claims or liability that may arise in
connection with any such use of my likeness and/or voice or the exercise of the rights granted herein, including any claims of defamation,
invasion of privacy, or infringement of moral rights, rights of publicity, copyright, or other personal or proprietary right.
I understand and agree that WHOLE FOODS MARKET is under no obligation to make any use of the recordings or the rights granted herein.
OPTIONAL
