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New Item Request Form
VENDOR INFORMATION
SUPPLIER NAME
(Required)
TODAY'S DATE
(Required)
MM slash DD slash YYYY
PRIMARY CONTACT NAME
(Required)
First
Last
PRIMARY CONTACT EMAIL
(Required)
# OF NEW ITEM(S) REQUESTED
Please list how many new items you will be submitting to Skurnik.
1
2
3
4
5
STATES SKURNIK IS AUTHORIZED TO SELL THESE SKUS
(Required)
NY
NJ
CT
PA
RI
OH
KY
IN
CA
ITEM #1 // BASIC SKU INFO
BRAND NAME
(Required)
SUB-BRAND NAME
NEW ITEM NAME / DESCRIPTION
(Required)
(List vintage here, if applicable)
BOTTLE SIZE
(Required)
CASE PACK
(Required)
FOB OR EX-CELLAR COST $ PER CASE
(Required)
DESIRED MSRP
(Required)
ORIGIN COUNTRY
(Required)
ORIGIN REGION / STATE / APPELLATION
(Required)
ABV
(Required)
COLA
Yes
Pending
COLA NO. / TTB ID
Is this new item associated with a certificate of label approval (COLA) number that is new to Skurnik? If so, please upload here a revised signed Letter of Agency (LOA) that includes the full item name.
Accepted file types: pdf, tif, Max. file size: 44 MB.
Is this item certified kosher?
No
Certified Kosher
Certified Kosher for Passover
Please upload the Kosher Certification:
Max. file size: 44 MB.
UPC CODE
SUPPLIER INTERNAL ITEM NUMBER
DOES THIS ITEM HAVE CONTINUITY
(Required)
Yes
No
IF LIMITED, WHAT IS SKURNIK'S ALLOCATION?
(Required)
ITEM #1 // REGISTRATION + COMPLIANCE INFO
GLOBAL ANNUAL PRODUCTION OF THIS NEW ITEM LESS THAN 1,000 GALLONS?
(Required)
Yes
No
BEEN IN THE MARKET BEFORE?
(Required)
Yes
No
WHICH MARKETS?
(Required)
CURRENT PRICING?
(Required)
CT REGISTRATION COSTS $200 PER COLA, AND IS VALID FOR THREE YEARS. SKURNIK PAYS HALF OF THIS REGISTRATION FEE, AND BILLS BACK THE SUPPLIER FOR THE REMAINING $100. DO YOU AGREE TO PAY THE $100 FEE TO REGISTER THIS ITEM?
(Required)
YES
NO
ITEM #1 // LOGISTICS + OPERATIONAL INFO
CASES PER PALLET
(Required)
CASES PER TIER
(Required)
DIMENSIONS OF EACH CASE
(Required)
ITEM #2 // BASIC SKU INFO
BRAND NAME
SUB-BRAND NAME
NEW ITEM NAME / DESCRIPTION
(Required)
(List vintage here, if applicable)
BOTTLE SIZE
(Required)
CASE PACK
(Required)
FOB OR EX-CELLAR COST $ PER CASE
(Required)
DESIRED MSRP
(Required)
ORIGIN COUNTRY
(Required)
ORIGIN REGION / STATE / APPELLATION
(Required)
ABV
(Required)
COLA
Yes
Pending
COLA NO. / TTB ID
Is this new item associated with a certificate of label approval (COLA) number that is new to Skurnik? If so, please upload here a revised signed Letter of Agency (LOA) that includes the full item name.
Accepted file types: pdf, tif, Max. file size: 44 MB.
Is this item certified kosher?
No
Certified Kosher
Certified Kosher for Passover
Please upload the Kosher Certification:
Max. file size: 44 MB.
UPC CODE
SUPPLIER INTERNAL ITEM NUMBER
DOES THIS ITEM HAVE CONTINUITY
(Required)
Yes
No
IF LIMITED, WHAT IS SKURNIK'S ALLOCATION?
(Required)
ITEM #2 // REGISTRATION + COMPLIANCE INFO
GLOBAL ANNUAL PRODUCTION OF THIS NEW ITEM LESS THAN 1,000 GALLONS?
(Required)
Yes
No
BEEN IN THE MARKET BEFORE?
(Required)
Yes
No
WHICH MARKETS?
(Required)
CURRENT PRICING?
(Required)
CT REGISTRATION COSTS $200 PER COLA, AND IS VALID FOR THREE YEARS. SKURNIK PAYS HALF OF THIS REGISTRATION FEE, AND BILLS BACK THE SUPPLIER FOR THE REMAINING $100. DO YOU AGREE TO PAY THE $100 FEE TO REGISTER THIS ITEM?
(Required)
YES
NO
ITEM #2 // LOGISTICS + OPERATIONAL INFO
CASES PER PALLET
(Required)
CASES PER TIER
(Required)
DIMENSIONS OF EACH CASE
(Required)
ITEM #3 // BASIC SKU INFO
BRAND NAME
(Required)
SUB-BRAND NAME
NEW ITEM NAME / DESCRIPTION
(Required)
(List vintage here, if applicable)
BOTTLE SIZE
(Required)
CASE PACK
(Required)
FOB OR EX-CELLAR COST $ PER CASE
(Required)
DESIRED MSRP
(Required)
ORIGIN COUNTRY
(Required)
ORIGIN REGION / STATE / APPELLATION
(Required)
ABV
(Required)
COLA
Yes
Pending
COLA NO. / TTB ID
Is this new item associated with a certificate of label approval (COLA) number that is new to Skurnik? If so, please upload here a revised signed Letter of Agency (LOA) that includes the full item name.
Accepted file types: pdf, tif, Max. file size: 44 MB.
Is this item certified kosher?
No
Certified Kosher
Certified Kosher for Passover
Please upload the Kosher Certification:
Max. file size: 44 MB.
UPC CODE
SUPPLIER INTERNAL ITEM NUMBER
DOES THIS ITEM HAVE CONTINUITY
(Required)
Yes
No
IF LIMITED, WHAT IS SKURNIK'S ALLOCATION?
(Required)
ITEM #3 // REGISTRATION + COMPLIANCE INFO
GLOBAL ANNUAL PRODUCTION OF THIS NEW ITEM LESS THAN 1,000 GALLONS?
(Required)
Yes
No
BEEN IN THE MARKET BEFORE?
(Required)
Yes
No
WHICH MARKETS?
(Required)
CURRENT PRICING?
(Required)
CT REGISTRATION COSTS $200 PER COLA, AND IS VALID FOR THREE YEARS. SKURNIK PAYS HALF OF THIS REGISTRATION FEE, AND BILLS BACK THE SUPPLIER FOR THE REMAINING $100. DO YOU AGREE TO PAY THE $100 FEE TO REGISTER THIS ITEM?
(Required)
YES
NO
ITEM #3 // LOGISTICS + OPERATIONAL INFO
CASES PER PALLET
(Required)
CASES PER TIER
(Required)
DIMENSIONS OF EACH CASE
(Required)
ITEM #4 // BASIC SKU INFO
BRAND NAME
(Required)
SUB-BRAND NAME
NEW ITEM NAME / DESCRIPTION
(Required)
(List vintage here, if applicable)
BOTTLE SIZE
(Required)
CASE PACK
(Required)
FOB OR EX-CELLAR COST $ PER CASE
(Required)
DESIRED MSRP
(Required)
ORIGIN COUNTRY
(Required)
ORIGIN REGION / STATE / APPELLATION
(Required)
ABV
(Required)
COLA
Yes
Pending
COLA NO. / TTB ID
Is this new item associated with a certificate of label approval (COLA) number that is new to Skurnik? If so, please upload here a revised signed Letter of Agency (LOA) that includes the full item name.
Accepted file types: pdf, tif, Max. file size: 44 MB.
Is this item certified kosher?
No
Certified Kosher
Certified Kosher for Passover
Please upload the Kosher Certification:
Max. file size: 44 MB.
UPC CODE
SUPPLIER INTERNAL ITEM NUMBER
DOES THIS ITEM HAVE CONTINUITY
(Required)
Yes
No
IF LIMITED, WHAT IS SKURNIK'S ALLOCATION?
(Required)
ITEM #4 // REGISTRATION + COMPLIANCE INFO
GLOBAL ANNUAL PRODUCTION OF THIS NEW ITEM LESS THAN 1,000 GALLONS?
(Required)
Yes
No
BEEN IN THE MARKET BEFORE?
(Required)
Yes
No
WHICH MARKETS?
(Required)
CURRENT PRICING?
(Required)
CT REGISTRATION COSTS $200 PER COLA, AND IS VALID FOR THREE YEARS. SKURNIK PAYS HALF OF THIS REGISTRATION FEE, AND BILLS BACK THE SUPPLIER FOR THE REMAINING $100. DO YOU AGREE TO PAY THE $100 FEE TO REGISTER THIS ITEM?
(Required)
YES
NO
ITEM #4 // LOGISTICS + OPERATIONAL INFO
CASES PER PALLET
(Required)
CASES PER TIER
(Required)
DIMENSIONS OF EACH CASE
(Required)
ITEM #5 // BASIC SKU INFO
BRAND NAME
(Required)
SUB-BRAND NAME
NEW ITEM NAME / DESCRIPTION
(Required)
(List vintage here, if applicable)
BOTTLE SIZE
(Required)
CASE PACK
(Required)
FOB OR EX-CELLAR COST $ PER CASE
(Required)
DESIRED MSRP
(Required)
ORIGIN COUNTRY
(Required)
ORIGIN REGION / STATE / APPELLATION
(Required)
ABV
(Required)
COLA
Yes
Pending
COLA NO. / TTB ID
Is this new item associated with a certificate of label approval (COLA) number that is new to Skurnik? If so, please upload here a revised signed Letter of Agency (LOA) that includes the full item name.
Accepted file types: pdf, tif, Max. file size: 44 MB.
Is this item certified kosher?
No
Certified Kosher
Certified Kosher for Passover
Please upload the Kosher Certification:
Max. file size: 44 MB.
UPC CODE
SUPPLIER INTERNAL ITEM NUMBER
DOES THIS ITEM HAVE CONTINUITY
(Required)
Yes
No
IF LIMITED, WHAT IS SKURNIK'S ALLOCATION?
(Required)
ITEM #5 // REGISTRATION + COMPLIANCE INFO
GLOBAL ANNUAL PRODUCTION OF THIS NEW ITEM LESS THAN 1,000 GALLONS?
(Required)
Yes
No
BEEN IN THE MARKET BEFORE?
(Required)
Yes
No
WHICH MARKETS?
(Required)
CURRENT PRICING?
(Required)
CT REGISTRATION COSTS $200 PER COLA, AND IS VALID FOR THREE YEARS. SKURNIK PAYS HALF OF THIS REGISTRATION FEE, AND BILLS BACK THE SUPPLIER FOR THE REMAINING $100. DO YOU AGREE TO PAY THE $100 FEE TO REGISTER THIS ITEM?
(Required)
YES
NO
ITEM #5 // LOGISTICS + OPERATIONAL INFO
CASES PER PALLET
(Required)
CASES PER TIER
(Required)
DIMENSIONS OF EACH CASE
(Required)
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