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<body>
<div id="bigtitle">流通环节食品供货商备案表 </div>
<table id="tab" width="1145" height="325" border="0" align="center" cellpadding="1" cellspacing="1" bgcolor="#000000">
<tr>
<td width="66" height="25" rowspan="3" bgcolor="#FFFFFF"><p align="center">供货商</p>
<p align="center">资料 </p></td>
<td width="213" height="25" bgcolor="#FFFFFF"><p align="center">名称 </p></td>
<td height="25" colspan="3" bgcolor="#FFFFFF"> </td>
<td height="25" align="center" bgcolor="#FFFFFF">地址 </td>
<td height="25" colspan="3" bgcolor="#FFFFFF"><p align="center"> </p></td>
</tr>
<tr>
<td height="25" bgcolor="#FFFFFF"><p align="center">负责人 </p></td>
<td height="25" colspan="3" bgcolor="#FFFFFF"> </td>
<td height="25" align="center" bgcolor="#FFFFFF">联系方式 </td>
<td height="25" colspan="3" bgcolor="#FFFFFF"><p align="center"> </p></td>
</tr>
<tr>
<td height="25" bgcolor="#FFFFFF"><p align="center">营业执照号码 </p></td>
<td height="25" colspan="3" bgcolor="#FFFFFF"> </td>
<td height="25" align="center" bgcolor="#FFFFFF">卫生许可证号码 </td>
<td height="25" colspan="3" bgcolor="#FFFFFF"><p align="center"> </p></td>
</tr>
<tr>
<td height="25" align="left" bgcolor="#FFFFFF"><p align="center">序号</p> </td>
<td height="25" align="center" bgcolor="#FFFFFF">商品名称</td>
<td width="56" height="25" bgcolor="#FFFFFF"><p align="center">规格 </p></td>
<td width="156" height="25" bgcolor="#FFFFFF"><p align="center">质检证明编号 </p></td>
<td width="93" height="25" bgcolor="#FFFFFF"><p align="center">其它资料 </p></td>
<td width="203" height="25" bgcolor="#FFFFFF"><p align="center">商品名称 </p></td>
<td width="67" height="25" bgcolor="#FFFFFF"><p align="center">规格 </p></td>
<td width="151" height="25" bgcolor="#FFFFFF"><p align="center">质检证明编号 </p></td>
<td width="75" height="25" bgcolor="#FFFFFF"><p align="center">其它资料 </p></td>
</tr>
<%
For I = 1 To 60
%>
<tr>
<td height="25" valign="top" bgcolor="#FFFFFF"><p><%=I%></p></td>
<td height="25" valign="top" bgcolor="#FFFFFF"> </td>
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<td width="156" height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
<td height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
<td width="203" height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
<td width="67" height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
<td width="151" height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
<td width="75" height="25" valign="top" bgcolor="#FFFFFF"><p> </p></td>
</tr>
<%
Next
%>
<tr>
<td height="80" valign="top" bgcolor="#FFFFFF"><p>档案情况 </p>
<p> </p></td>
<td height="80" colspan="4" valign="top" bgcolor="#FFFFFF"><p>供货商确认签字及开具《销货清单》使用的印章清样：</p>
<p style="text-align:right;margin-bottom:5px;margin-top:40px;">年 月 日 </p> </td>
<td height="80" colspan="4" valign="top" bgcolor="#FFFFFF"><p>协会审核人签字及盖章：</p>
<p style="text-align:right;margin-bottom:5px;margin-top:40px;">年 月 日 </p></td>
</tr>
</table>
<div id="bottom">说明：1.查验备案的营业执照、许可证及质检合格证明等复印件需加盖申请供货商的红章确认。 <br />
2.此表作为索证索票依据保存二年。 </div>
</body>
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