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DISTRIBUTORSHIP APPLICATION FORM FOR LONG LIFE-2024 (2)

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MUKURWE-INI WAKULIMA DAIRY

LTD.
P.O BOX 232-10103, MUKURWE-INI.
TEL: 0202046895/0722814900
E-MAIL: info@wakulimadairy.co.ke / wakulimakenya2010@yahoo.com

CASH ON ORDER / CASH ON DELIVERY & LONG LIFE APPLICATION /PARTNER FORM.

SECTION 1 : DISTRIBUTOR PERSONAL DETAILS

A. CORPORATE CLIENTS

Company Name _____________________________________________________


Limited co / public limited co /others.
[Pls specify] _____________________________________________________
Address _____________________________________________________
Telephone (office & Mobile) _____________________________________________________
Registration Certificate No. _____________________________________________________
Principal Contact Email. _____________________________________________________
Names of Directors 1. _____________________________________________________
2. _____________________________________________________
3. _____________________________________________________

B. INDIVIDUAL CLIENTS

Distributors Name __SAMUEL NDUNG’U GAKURU__________________________


Address . __P.O.BOX 4550-40200,KISII_______________________________
Telephone . __0115783534__________________________________________
Pin Number . __A022871048U________________________________________
ID. Number . ___42188257___________________________________________
Email address. ___samuelndunguweb@gmail.com_____________________________

SECTION II : GENERAL INFORMATION

1. Full details of area of operation ___Its within the outskirts of the town near tarmac road
400meters to Kisii town .
2. Facilities available for doing the business (eg Vans)
1. _MOTOR BIKES________________________________________________________
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2. ____________________________________________________________________
3. Amount paid as deposit ______Ksh70,000___________________ (proof of payment
required).
4. Distributor’s physical Depot. ___KISII TOWN JOGOO_____________________

SECTION III : REQUIREMENTS

In order to qualify for appointment as a company distributor, one must have the following
requirements: -

1. Own means of transport eg bicycles, hand carts, pick-ups, wheelbarrows for use in
distributing the products.

2. Enough labour force, i.e. staff to ensure proper coverage of the area and efficiency in
running the business.

3. Enough capital to make sure that the whole invoice is paid.

4. Enough storage facility including a large well – ventilated warehouse measuring a


minimum of 1002 ft and a refrigeration unit. This is to ensure safe keeping of the
products in case of excesses. [ This applies to super distributor].

5. Copy of Original ID Card and PIN Certificate. (Individual applicants).

6. Copy of registration certificate, copy of M.O.A / AOA, PIN Certificate and ID Copies for
the Directors. (Corporate Applications).

SECTION IV : TERMS AND CONDITIONS

1. The order must be paid in full before delivery.

2. Minimum order placed should be at least 50 cartons

3. All deliveries must be paid for in cases of cash on delivery.

4. If no proof of payment i.e. Current cheque on delivery /Mpesa payment via paybbill /till
message produced at the time of delivery in the case of cash on delivery mode, the
goods shall be returned.

5. All distributors must adhere to the boundaries as indicated in the application form.
Encroaching on other people’s areas will lead to a disciplinary action.

6. Distributors are required to conduct themselves with dignity while on business so as to


portray the proper image of the company. Distributors’ agents supplying milk to the
shops must always be neat.

7. Distributors will not be allowed to raise or lower the price of company products without
the authority of the company. Any changes in prices will be communicated to the
distributors before the effective date.

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8. All distributors are required to fully co-operate with the company so as to ensure a
successful business partnership. The company will be holding periodical meetings with
distributors so as to discuss business matters. However, this will be totally at the
discretion of the management.

9. Distributors are also required to co-operate with area managers who will be assigned to
their respective territories in creating business strategies so as to maximize on both
volumes and coverage.

10.Distributors shall be working on strictly set targets which shall be communicated to


them in writing. They will be working closely with area managers to make plans on
achieving the sales targets.

11.Any party can terminate this contract upon a notice of 30 (thirty) days’ notice. Any
refund /monies to either party should be processed within this period.

SECTION V : DISTRIBUTORS DECLARATION.

I __Samuel Ndung’u Gakuru_______ declare that I have carefully read and understood the
above terms and conditions. I hereby commit myself to abide by the said terms and
conditions.

Name . ______ Samuel Ndung’u Gakuru ________________________________________


ID Number / Company registration Number
____42188257_______________________________________
Sign (Stamp). _________________________________________________________________
Date. ___ February 21, 2025______________________________________________
SECTION VI : FOR OFFICIAL USE ONLY
Application received on : _________________________________________
Application approved / declined : _________________________________________
Reasons for decline : _________________________________________
_________________________________________
Customer Service Rep. : _________________________________________
Checked by: (Regional supervisor): : _________________________________________

Sales & Marketing Manager : _________________________________________

Credit control officer: ; _________________________________________

Approved by: C.E.O : _________________________________________

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N/B. The Company reserves the right to approve or decline an application and is not bound to
give reasons
Reasons thereof.

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