For use by Pall US Plants when

creating a US Supplier.

New U.S. Supplier On-Boarding Packet

The below table has been designed to provide new suppliers with a summary of the general documentation requirements
that should be included as part of your completed on-boarding packet.

Please note, additional documentation may be required depending on the nature of the products and/or services that may be
provided. Your Pall Representative will notify you if additional documentation is necessary.

New Supplier Documentation Requirements: References:

New Supplier Request Form: The form is located
☐ Completed New Supplier Request Form on page 2 of this packet.

Acceptance of Pall Corporation’s Code of Conduct Code of Conduct Acceptance: Detailed

instructions are provided on page 3 of this
packet.
If providing products and/or services to Pall Corporation, the
☐ completed New Supplier Form must include a Code of Conduct
Code of Conduct Portal Link:
Portal Reference Number in the provided field. Acquiring a
http://www.pall.com/supplier/certification
reference number will require signing up on our Supplier Portal and
accepting Pall Corporation’s Code of Conduct.

☐ Completed W9 Tax Form https://www.irs.gov/pub/irs-pdf/fw9.pdf

Business Letterhead*

☐ Document containing supplier’s business letterhead details must be

provided. Supplier’s remit to and buy from address details should be
included.

Payment: Pall Corporation’s payment terms are NT90 or Credit Card

Payment at month end.

Payment Method Credit Card

If preferred payment method chosen on the New Supplier Request
☐ Form is Credit Card, a completed Credit Card Agreement
is required.
NOTE: SUPPLIER MUST HAVE THE CAPABILITIES TO PROCESS CREDIT CARD
PAYMENTS IN ORDER TO CHOOSE THIS PAYMENT METHOD OPTION.
Credit Card Agreement: Reference pages 4-5 of
this packet for details regarding enrollment into
the Credit Card Program and the agreement that
must be completed if your business chooses this
payment method option.

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

 Payment Method ACH or Check

*If preferred payment method chosen on the New Supplier Request

Form is ACH, electronic bank transfer, please ensure to include the
☐ payment banking details on the above mentioned business
letterhead.

If payment method Check is chosen, business letterhead is still

required, just omit the banking details.

FOR USE BY PALL U.S. PLANTS WHEN CREATING A U.S. SUPPLIER

LEGAL BUSINESS NAME:      

IS YOUR BUSINESS A DANAHER SUBSIDIARY? ☐ YES or ☐ NO

DOES YOUR BUSINESS HAVE AN OPEN INVOICE PENDING PAYMENT FROM PALL CORPORATION? ☐ YES or ☐ NO
IS THERE A CONTRACTUAL COMMITMENT* OR LEASE TO PURCHASE GOODS AND/OR SERVICES
FROM PALL CORPORATION WITHIN SERVICE AREAS OF IT, WAREHOUSING, AND/OR MARKETING? ☐ YES or ☐ NO
*Click here, then click the drop-down arrow to see the definition of
WILL YOUR BUSINESS INTEGRATE WITH ANY PALL SOFTWARE SOLUTION? ☐ YES or ☐ NO
WILL YOUR BUSINESS COLLECT OR PROCESS PALL EMPLOYEE PERSONAL DATA*? ☐ YES or ☐ NO
*Click here, then click the drop-down arrow to see the definition of
If answered yes to the above personal data question, please identify your
relationship with Pall as it pertains to personal data collection and processing.      
WILL YOUR BUSINESS COLLECT AND STORE EMPLOYEE PERSONAL DATA FROM PALL TO FULFILL
THE BUSINESS PROPOSED SERVICES BEING PROCURED? ☐ YES or ☐ NO
WILL YOUR BUSINESS COLLECT AND PROCESS EMPLOYEE PERSONAL DATA FROM PALL TO FULFILL
THE BUSINESS PROPOSED SERVICES BEING PROCURED? ☐ YES or ☐ NO

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

ADDRESS INFORMATION
REMIT TO ADDRESSS – Payments will be directed to this address.
STREET:      
ADDRESS:
CITY:       STATE:       POSTAL CODE:       COUNTRY:      
PHONE NO:       FAX NO:       EMAIL:      
BUY FROM ADDRESS – Purchase orders will be directed to this
STREET:      
CITY:       STATE:       POSTAL CODE:       COUNTRY:      
PHONE NO:       FAX NO:       EMAIL:      

SUPPLIER PORTALS
THE SUPPLIER PORTALS SECTION IS ONLY REQUIRED FOR BUSINESSES THAT WILL BE PROVIDING PRODUCTS AND/OR SERVICES TO PALL CORP.
1. Visit the Link provided: http://www.pall.com/supplier/certification
2. Review certification/questionnaire descriptions and determine if applicable to your business (Code of Conduct Cert. Required).
3. After completing applicable certifications/questionnaires, return the appropriate reference number(s) provided by the system.
CODE OF CONDUCT PORTAL REFERENCE # (Required): Provide required Portal Ref. #
SMALL AND/OR MINORITY OWNED BUSINESS PORTAL REFERENCE #: Provide a Portal Ref. # or put N/A if not applicable
SMALL AND/OR MINORITY OWNED BUSINESS CODE: Click here to choose a code or select N/A if not applicable
CONTROL
W9 Tax Form is required for all domestic suppliers providing Reference hyperlink: http://www.irs.gov/pub/irs-pdf/fw9.pdf
products and/or services to our business.
FEDERAL ID NO:       SOCIAL SECURITY NO If Individual/sole proprietor:      

FINANCE
PAYMENT TERMS: Pall’s payment terms are NT90 or Credit Card (end of month payment, reference pages 4-5 for additional details).
“Other” is only an available option for reimbursements, utility,
CHOOSE TERMS: ☐ NT90 ☐ CREDIT CARD ☐ OTHER legal, & beneficiary payments. Please provide explanation.

Click here to choose payment

PAYMENT METHOD: BANK ACCT HOLDER:      
method.
BANK COUNTRY:       BANK KEY/ROUTING #:       BANK ACCT#:      

ACCOUNTING CORRESPONDENCE – Remittance contact details

ACCT CONTACT:       PHONE: EMAIL:

PURCHASING DATA
ORDER CURRENCY:       INCO TERMS: Click here to choose terms

Instructions to complete the Supplier Portals Section of the

New Domestic Supplier Request Form

Please do not leave fields blank on this section of the form.

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

SUPPLIER PORTAL LINK: http://www.pall.com/supplier/certification

Code of Conduct Portal Reference # Field

All suppliers providing goods and/or services to Pall Corporation are required to complete the Code of Conduct
Certification.

Once complete, please populate the Portal Reference # provided by the system onto the New Supplier Request
Form.

Note: In specific circumstances, exceptions may be granted to the Code of Conduct Agreement. If a supplier is not willing to
accept Pall Corporation’s Code of Conduct Agreement please notify your Pall Representative.

Small and/or Minority Owned Business Portal Reference # and Code Fields

I. If the supplier is currently registered with the government as a Small and/or Minority owned Business and
would like to inform Pall Corporation, please proceed with completing the Small and/or Minority owned
Business Status Questionnaire. Once complete, the Indicator Code chosen on the Questionnaire and the
Portal reference # (both provided by the system) must be populated onto the New Supplier Request Form.

II. If the Supplier does not wish to inform us or is not registered with the government as a Small and/or Minority
owned Business, both fields should be marked N/A. If these fields are left blank this will designate N/A, not
applicable to the business.

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

 Pall Corporation
25 Harbor Park Drive
Port Washington, NY 11050
Email: Vendor_Invoices@pall.com

Credit Card Usage Agreement

This agreement is intended to clarify the terms of the program and expectations regarding usage.

Please ensure your business has the capability to process credit card payments prior to completing this
agreement. Paypal is not accepted.

Credit Card Number

The first 10 digits of the credit card number will be communicated to you from Pall Corporation’s Credit Card
Administrator at the time of enrollment into the Credit Card Program. The last four digits of the credit card number will
be communicated in the monthly payment authorization email.

Terms

Per our agreement, we will be issuing payment at a term of Net 00 Credit Card. You will be authorized to charge our
Credit Card for selected invoices that have been approved by the 28th day of the month (or next business day), and are due
to be paid per negotiated terms, and have been authorized for payment via email alert. Pall Corporation is not liable for
any processing fees that your company may incur as part of this process. If for any reason, you are removed from the
Credit Card program, supplier’s terms will default to Net 90 terms.

Example: Net 00, CC28

Invoice Date: January 1st
Credit Card Email Alert: January 28
Supplier Charges Pall Corporation’s credit card
Supplier receives payment within 36 hours

Invoices

Please continue to remit invoices as you have done in the past by emailing them to the address below. Before an invoice
can be approved for Credit Card payment, Pall Corporation A/P must complete a match of the PO, invoice and PO receipt.
Invoices cannot be validated if sent to Pall Corporation without references to Pall Corporation purchase order numbers.
The invoice quantities should equal the unit of measure stated in the Pall Corporation purchase order. This agreement is
not a guarantee that invoices submitted before the 28th day of the month will be paid by the 28th day of the month due to
standard A/P processing backlog. During the Pall Corporation cut-over period to configure our SAP system, there is a
potential for open purchase orders and invoices to experience payment fluctuations. As an added checkpoint, your
company must email invoices to Vendor_Invoices@pall.com

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

Authorization

Every 28th day of the month (or next business day), you will receive an e-mail communication authorizing your company
to charge Pall Corporation’s credit card for a series of invoices that have been authorized. It is important that you process
a charge only for those invoices authorized. If you have questions, please
contact your accounts payable representative. Any unauthorized charges to our Credit Card will be disputed and
denied through MasterCard.

By signing this form, your company agrees not to use this card for anything beyond the payment of authorized invoices.
Any illegal use of the card will be investigated and prosecuted. As there are multiple companies under Pall Corporation,
please be sure that you charge the correct invoices to the correct card if you have supplier relationships with more than one
Pall Corporation facility.

Merchant Transaction Spend Threshold

Supplier is responsible to modify their profile with their merchant bank to ensure the merchant transaction spend threshold
matches or exceeds the average monthly sales to Pall Corporation. 

Initial:      

By signing this agreement, you and your company agrees to abide by the terms set forth and accept any responsibility for
misuse of Pall Corporation purchasing card caused by employees of your company.

Physical Signature Required.    

Authorized Supplier Signature Date

SUPPLIER COMPLETE: Please do not leave fields blank.

Employee Name:      

Date:      
Position:      
Company Name:      
Email Address For
Credit Card Alerts:      
AR Contact Name:      
AR Contact Phone #:      

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19

Please sign, scan and email the entire agreement to your Strategic Sourcing/Procurement contact at Pall
Corporation. Once Pall Corporation receives a signed agreement, the activation process will commence. Once
completed, a Pall Credit Card Administrator will contact supplier.

New U.S. Supplier On-Boarding Packet – Version 11 – Americas – 10/11/19