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Sample Request Web Form

  • MM slash DD slash YYYY
  • :
  • DiCarlo Number Cases Needed Item Description Reason for Request Deduct off Invoice Billed To Actions
               

  • A $10.00 PER CASE SERVICE CHARGE WILL BE APPLIED TO ANY EMERGENCY SAMPLES!

    * Sample requests must be emailed or faxed to ‘Samples’ at samplerequest@dicarlofood.com / 631-758-6096, at least 24 hours in advance, there will be no exceptions.

    ** Upcharge for sample requests will be $7.50 per case. You must specify deduction or billing. If you do not the charge will be automatically deducted from the invoice.

    *** Please fill the form out in its entirety, a separate form should be filled out for each invoice or vendor.

    If sending a check or credit memo please send directly to Sunil Chadha, Purchasing Dept., and specify “For Samples”, the invoice number must be on all correspondence.