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Northwest Missouri State University

Request for Vendor/Item Action Form

Member Information

Name:
Contact Person:
Phone:
E-mail:

Vendor Information

Vendor Name:
(on receiving/P.O. copy)

Item # and Description:

Check All That Apply :
Late delivery
Unauthorized substitution
Poor quality/workmanship
Failure to respond promptly to service calls
Failure (or slow) to replace damaged goods
Unacceptable over shipment
Shortage(s) in delivery
Incorrect invoicing
Failure to meet specifications
Wrong item shipped
Cancel due to late delivery
Gave false or misleading information
Failure to sort items by department
Other

Comments: