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Vendor Management Polices and Forms
Note: The following documents are in .pdf format.
You must use the Acrobat Reader to access them.
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Vendor Management Policies
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Vendor Management Forms
Authorization Agreement for Direct Deposit (ACH Credits) Form - This form is used by authorized retailers to document a change in financial institution and/or bank account number (Using this form will help to ensure that ACH electronic deposits are received and posted correctly.)
Retailer Incident/Complaint Report Form - This form is used to document complaints file against a participant and/or improper use of WIC food instruments (checks).
Retailer Material/Supply Request Form - This form may be used by retailers to request additional materials/supplies from the VA WIC Program, such as food list, tip cards, shelf labels, window decals, etc.
Retailer Price Survey Form - This form is used to document the highest shelf prices of approved food items and infant formulas. It mirrors the online forms used with the Retail Store Management System (RSMS).
Retailer Rubber Stamp Order Form - This form may be used by authorized retailers to order a replacement rubber stamp for endorsing WIC food instruments (checks).
Virginia WIC Program Vendor Team Contacts - This file contains a list of VA WIC Program Vendor Team contacts (including names, postal and email addresses, telephone, and fax numbers).
Virginia WIC Program Wholesalers and Distributors Listing - This file contains a list of suppliers used by VA WIC Authorized retailers.
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