Company Name

Your Name

Your Email

Date

Name of person who will make the final decision to permit the installation of the machines

Company Address

How many staff are there on an average day? How many staff are there on an average day? <80 80-100 100-150 >150

What products are you looking for? What products are you looking for? Snacks Cool Drinks Snacks & Cool Drinks

Night Shifts? Night Shifts? Yes No

If YES to above, how many times a month do you have night shifts?

How many staff on each night shift?

Company opening time? Company opening time?24hrs 0r open before 5am5am6am7am8am9am

Company closing time? Company closing time?3pm4pm5pm6pm7pm8pm9pm10pm11pmafter 11pm

Is there a GOODS LIFT (not a standard lift) to transport machines if needed? Is there a GOODS LIFT (not a standard lift) to transport machines if needed? Yes No

Is there a plug point at the proposed site for the machine? Is there a plug point at the proposed site for the machine? Yes No

Do you currently already have vending machines or have you had in the past? Do you currently already have vending machines or have you had in the past? Yes No

Do you currently have a catering company or any other vendor supplying food to staff? Do you currently have a catering company or any other vendor supplying food to staff? Yes No

If YES to above please supply some further info

Give a description of proposed site for the machines (eg in staff canteen, on factory floor,etc)