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TimestampOrganization NameBest Single Point of Contact: First NameBest Single Point of Contact: Last NameBest Single Point of Contact: EmailBest Single Point of Contact: PhoneWhat quantity of face shields do you currently have available to be shipped?How many face shields can you ship each day? If anything changes (e.g. your facility can ship more or less masks per day), please resubmit the form with the updated information.In what form/state (e.g. fully assembled or kit) will you ship the face shields to medical facilities? If you are not the end point in the supply chain, please do not continue filling out this form.Facility Street AddressCityStateZip CodeCan you ship anywhere in the US or Canada?What forms of payment will you accept?
2
3/23/2020 22:49:06Summit Medical, LLCKevinMcIntosh
kmcintosh@innoviamedical.com
6517893931TBD0Either/Both815 Vikings ParkwayEaganMinnesota55121YesCredit/Debit Card, prepay
3
3/23/2020 23:26:32
UW-Madison DoIT Digital Printing and Publishing Services
GeoffLarsongeoff.larson@wisc.edu608-263-9002
By next Monday, 3/30/20, I will have enough material to produce 25,000 shields. We are in the process of procuring additional materials as well.l
0Either/Both30 East Campus MallMadisonWisconsin53715Yes
Credit/Debit Card, Purchase Order, Check or Campus Funding UDDS Code
4
3/24/2020 6:47:42George P. JohnsonSeanSweeneysean.sweeney@gpj.com60843860930500Either/Both423 Liberator LnSmyrnaTennessee37167YesPurchase Order
5
3/24/2020 7:23:32PixMobaudreyhouleah@pixmob.com438722626710001000Fully assembled103 Rue De Louvain OMontréalOutside of the USAH2N 1A3YesPayPal, Purchase Order, wire transfer
6
3/24/2020 10:21:16
Gibraltar Plastic Products
KeithJacobs
kjacobs@gibraltarplastic.com
818365931800Fully assembled12885 Foothill BlvdSylmarCalifornia91342YesCredit/Debit Card, Purchase Order
7
3/24/2020 10:55:06Rustic HustleKyrylTsymbalkyryltsymbal@gmail.com64740377450300Kit form1610 sideroad 10tottenhamOutside of the USAl0g1w0YesCredit/Debit Card, PayPal
8
3/24/2020 12:07:23Object ConstructionAlexPandjiris
Alex@objectconstruction.com
323-710-402100Either/Both3869 Medford StLos AngelesCalifornia90063YesCredit/Debit Card, PayPal, venmo
9
3/24/2020 14:34:33
Hardy Engineering & MFG
GayHardygay@hardyem.com206-714-538300Kit form120-37th ST NEAuburnWashington98002YesPurchase Order, Check
10
3/24/2020 17:05:56Midwest PrototypingSuziGrundahl
suzi.grundahl@midwestproto.com
608-437-140005000Either/Both108 S 2nd St.Mount HorebWisconsin53572YesCredit/Debit Card, Purchase Order
11
3/24/2020 21:30:00
Arsco Custom Metals/Arsco 3D
GarrettGebhardtggebhardt@arsco3d.com513.505.3375500200Fully assembled11510 Grooms RdCincinnatiOhio45242YesCredit/Debit Card, PayPal, Purchase Order
12
3/25/2020 9:41:19PPE Face ShieldsBudCarlsoninfo@ppefaceshields.com515-240-973902000Either/Both485 S 46th St
West Des Moines
Iowa50265YesCredit/Debit Card, PayPal, Purchase Order, Check
13
3/25/2020 9:47:48Coaster CyclesJustinBrucejustin@coastercycles.com406-924-12001000010000Either/Both9257 BONNER MILL RDBONNERMontana59823YesCredit/Debit Card, PayPal, ACH, Wire
14
3/25/2020 10:41:28
Sleep Environment Innovations
GregKrzecki
Heliusengineering@gmail.com
41497505870250Either/Both6030 South Jasper AveMilwaukeeWisconsin53207YesCredit/Debit Card, PayPal, Purchase Order
15
3/25/2020 12:07:34Benchmark SafetyAmyFitch
amyf@benchmarkthermal.com
630-674-615701000Fully assembled13185 Nevada City AveGrass ValleyCalifornia95945YesCredit/Debit Card, ACH and Wire Transfer
16
3/25/2020 13:36:54Vinyl ArtDennisLeberecht
dennisleberecht@vinylart.com
847 778 20572200500Fully assembled15300 28th Ave NorthMinneapolisMinnesota55447YesCredit/Debit Card, Purchase Order
17
3/25/2020 14:15:56Franzen GraphicsNickFranzen
nfranzen@franzengraphics.com
920-254-127420002500Fully assembled5300 Highway 42 NorthSheboyganWisconsin53083YesCredit/Debit Card, Purchase Order, Check
18
3/25/2020 14:21:44Prometheus FuelsRobMcGinnisrob@prometheusfuels.com91756563091000
1000, 300 fully assembled
Kit form601 Swift St.Santa CruzCalifornia95060YesCredit/Debit Card, PayPal, Purchase Order, wire transfer
19
3/25/2020 14:23:26BeSide DigitalMatthewHabermatthew@besidedigital.com617435925705500Fully assembled630 Flushing AveBrooklynNew York11206YesCredit/Debit Card, Purchase Order
20
3/25/2020 14:24:59PaperGala LLCMikeLyonsmike@papergala.com989-912-451740005000Either/Both
2220 E Ohmer Rd STE B
MayvilleMichigan48744YesCredit/Debit Card, PayPal
21
3/25/2020 14:43:22IMCTylerOlsontylermolson@gmail.com651-274-754250000100000Fully assembled4284 Shoreline DrSpring ParkMinnesota55384YesCredit/Debit Card, Purchase Order, ACH/Wire
22
3/25/2020 15:11:48
Welch Fluorocarbon, Inc.
NicoleDeBloisndeblois@wfinc.com603-553-92100500Fully assembled113 Crosby Rd. Unit 10DoverNew Hampshire03820YesCredit/Debit Card, Purchase Order
23
3/25/2020 15:49:17Axial3DRob Fisherr.fisher@axial3d.com248-798-3291200005000Either/Both113 N May StChicagoIllinois60607YesCredit/Debit Card, Purchase Order
24
3/25/2020 21:04:36Adaptive Energy, LLCRanvirGujral
ranvir.gujral@adaptiveenergyllc.com
1650799473401000Either/Both5500 S STATE RDAnn ArborMichigan48108YesCredit/Debit Card, Purchase Order
25
3/25/2020 22:07:25N/AJasonLavenderjasonslavender@gmail.com91777071151000Fully assembled35 Whitlaw LaneChappaquaNew York10514YesPayPal, Venmo
26
3/26/2020 7:05:41Kohler CoCindyHowley
cindy.howley@kohler.com
920-912-847110,000 - Donations0Fully assembled444 Highland Drive KohlerWisconsin53044YesPurchase Order
27
3/26/2020 9:03:12
Innovative Display & Design
Thomas Milanot.milano@innov8.com8604713495100500Either/Both75 Cascade Blvd.MilfordConnecticut06460YesCredit/Debit Card, bank wire
28
3/26/2020 9:34:29Elevate97Bill Hawkerbhawker@elevate97.com313402431840004500Fully assembled1085 PARKVIEW ROADGREEN BAYWisconsin54313YesPurchase Order, EFT/ACH and check
29
3/26/2020 10:27:36XPEL, Inc.RobertBeznerrbezner@xpel.com210.678.3745 50005000Fully assembled618 W. Sunset Rd.San AntonioTexas78216YesCredit/Debit Card, Purchase Order
30
3/26/2020 11:47:33Mokeeta, LLC.AnthonyKlingcontact@mokeeta.com61241452120200Either/Both1224 Quincy St NEMinneapolisMinnesota55413YesCredit/Debit Card, PayPal, Purchase Order, Check
31
3/26/2020 13:26:37PerspectivesMichaelLevymikelevy1@me.com412-427-416516003500Fully assembled3005 Venture CourtExportPennsylvania15632YesCredit/Debit Card
32
3/26/2020 14:41:06
Sound Rubber Company, LLC
DylanMorano
dmorano@soundrubber.com
860510334800Fully assembled
410 Industrial Park Road
Deep RiverConnecticut06417YesCredit/Debit Card, Purchase Order, Check
33
3/26/2020 14:45:05
PRECISION GLOBAL SYSTEMS
RichardNajarianrichard@pgsinc.net24870998781000012500Fully assembled1600 E. Big Beaver Rd.TroyMichigan48083YesCredit/Debit Card, PayPal, Purchase Order
34
3/26/2020 16:53:37Acrylic Idea FactoryGuileEliasguile@acrylicidea.com52043744880500Either/Both8100 E Research Ct.TucsonArizona85710Continental USCredit/Debit Card, PayPal, Purchase Order
35
3/27/2020 8:56:33AlconStephenCollins
stephen.collins@alcon365.com
81791549170500Either/Both6201 South FreewayFort WorthTexas76134Yes
Alcon is a huge healthcare corporation, we would likely do this pro bono. If that isn't an option, we could easily figure out payment methods.
36
3/27/2020 9:09:11Lakeview IndustriesJohn Schwanke
jschwanke@lakeviewindustries.com
612-991-808020000250000Fully assembled2100 Commerce DriveCarverMinnesota55315YesCredit/Debit Card, Purchase Order
37
3/27/2020 9:38:57PSC INDUSTRIESTIMWEBBtimw@pscindustries.com502689956210001000Fully assembled
1100 West Market Street
LOUISVILLEKentucky40203YesCredit/Debit Card, Purchase Order, WIRE TRANSFER
38
3/27/2020 10:09:01
Sound Rubber Company, LLC
DylanMorano
dmorano@soundrubber.com
86051033480500Either/Both
410 Industrial Park Road
Deep RiverConnecticut06417YesCredit/Debit Card, Purchase Order, Check
39
3/27/2020 10:55:42Pawstar, Inc.ScottGracemeow@pawstar.com262-664-4046050Fully assembled1236 13th St.RacineWisconsin53403YesCredit/Debit Card, PayPal
40
3/27/2020 13:11:36WaterTectonicsBrantHayes
brant.hayes@watertectonics.com
42577331610100Fully assembled
6300 Merrill Creek Pkwy
EverettWashington98208YesCredit/Debit Card, Purchase Order
41
3/27/2020 13:31:56Queen City PolymersGreg Hendrenghendren@qcpinc.net513-259-779005000Either/Both
6101 Schumacher Park Dr
West ChesterOhio45069YesCredit/Debit Card, PayPal, Purchase Order
42
3/27/2020 13:45:08SERTHelmAshiblieppe@sert.us70370592660200Fully assembledKennedy StreetWoodbridgeVirginia22191YesCredit/Debit Card, PayPal, Purchase Order
43
3/27/2020 14:13:45Mursix CorporateSusanMurray Carlockscarlock@mursix.com3173713560020000Either/Both
2401 North Executive Park Road
YorktownIndiana47396YesCredit/Debit Card, PayPal, Purchase Order
44
3/27/2020 14:29:27PlaqueMAKER PLUSTracyPereira
tracy@plaquemakerplus.com
317.594.555601000Fully assembled
10080 E 121ST STR Ste 118
FISHERSIndiana46037YesCredit/Debit Card, PayPal, Purchase Order
45
3/27/2020 15:40:35Canvas ProsRobertMartins
canvaspros2020@gmail.com
401265324701500Fully assembled500 Pullman Rd EdgewaterFlorida32132YesCredit/Debit Card, PayPal, Purchase Order, wire
46
3/27/2020 20:54:30SITU FabricationBasarGiritbasar@situ.nyc728237168830002000Fully assembled
63 Flushing Ave Bldg 132
BrooklynNew York11205YesCredit/Debit Card, Purchase Order
47
3/27/2020 23:57:40AfkeaMarkusBachmannmarkus@greenline.za.com061200223350500Either/Both76 stanhope roadgermistonOutside of the USA1401
we need to check with authorathies
Purchase Order
48
3/28/2020 8:46:10PhotoBarnToddMcCormick
todd.mccormick@photobarn.com
80172545061001000Fully assembled10529 Kingston PikeKnoxvilleTennessee37922YesCredit/Debit Card, PayPal, Wire/Bank Draft
49
3/28/2020 12:43:43michaelv.designMichaelVlietstramike@michaelv.design909-392-18000500Fully assembled580 E. Arrow HighwaySan DimasCalifornia91773YesCredit/Debit Card, PayPal, Venmo, Zelle, ACH
50
3/28/2020 14:02:07
AMRoC Fab Lab/Foundation for Community Driven Innovation (nonprofit)
TheresaWillinghamTerri@ffcdi.org 813-728-2822050Either/Both
2149 University Square Mall
TampaFlorida33612Yes
Credit/Debit Card, PayPal, costs will be minimal, just to cover materials and staff
51
3/28/2020 16:15:45
Wahl Clipper Corporation
ChristopherKuntzickuntzi@wahlclipper.com81576269471000000100000Either/Both
2900 North Locust Street
SterlingIllinois61068YesTBD
52
3/28/2020 18:09:09
Dakonte Product Group, Inc
DonaldHill
office@dakonteproducts.com
41472766810500Either/Both6615 W Mill RoadMilwaukeeWisconsin53218YesCredit/Debit Card, PayPal, Purchase Order, ACH
53
3/29/2020 0:48:25North StarJordan Bowdenjordan.j.bowden@gmail.com514 243 40140200Fully assembled3908 Blvd St. Laurent MontrealOutside of the USAH2S 1{7
Addressing Local demand currently
Purchase Order
54
3/29/2020 6:34:03Premier Display Inc.Dan Steinpremdisplay@gmail.com6313064945100100Either/Both2979 Judith DriveBellmoreNew York11710Only US continentalPayPal
55
3/29/2020 9:09:28www.eyefaceshield.comJon DreznerJon Dreznerorders@eyefaceshield.com609-558-96111000010000Fully assembled90 Battle RoadPrincetonNew Jersey08540YesCredit/Debit Card, PayPal, Wire
56
3/29/2020 13:19:26
Siegfried Consultants LLC
SteveSiegfried
steve@siegfriedconsultantsllc.com
5862451225400300Fully assembled535 Mary Ellen RoadRochester HillsMichigan48307YesCredit/Debit Card
57
3/29/2020 13:57:49
AutoMate Scientific, Inc.
JoeCordesshields@autom8.com510-845-62830100Either/Both812 Page StreetBerkeleyCalifornia94710YesCredit/Debit Card, PayPal, Purchase Order
58
3/29/2020 14:34:12
Custom Choice Acrylics
Paul Bunning
paul@customchoiceacrylics.com
740-213-201820000400Fully assembled
155 P. Rickman Industrial Drive-Suite 100
Holly SpringsGeorgia30115YesCredit/Debit Card, Purchase Order
59
3/29/2020 16:11:53Stencil EaseJamesRandolphjimr@stencilsease.com847-2246251100010000Either/Both7 Center Road WestOld SaybrookConnecticut06475YesCredit/Debit Card, PayPal, Purchase Order
60
3/29/2020 16:42:51The Beistle CompanyDavidGoodedmgoode@beistle.com717-261-60323000030000Fully assembled1 Beistle PlazaShippensburgPennsylvania17257YesCredit/Debit Card, Purchase Order, Wire Transfer
61
3/29/2020 17:34:39KF PlasticsSimonClarkesales@kfplastics.com.au02974060001001000Fully assembled
90 Vore Street Silverwater NSW
SydneyOutside of the USA2128AustraliaCredit/Debit Card, PayPal
62
3/29/2020 17:48:48North Design BuildKennethTschernow
Kennetht@northmarketing.ca
141681831030500Fully assembled100 Frid StreetHamiltonOutside of the USAL8P4M4 YesCredit/Debit Card, Purchase Order
63
3/29/2020 18:35:24Intermold CorporationKevinHueykhuey69377@aol.com30224534651001000Either/Both2690 Williamsville RdHOUSTONDelaware19954YesCredit/Debit Card, Purchase Order
64
3/29/2020 20:23:26GuardianWayneArrowoodarrowoodinc@gmail.com9316291040100100Fully assembled732 TOBEN TER
LAWRENCEBURG
Tennessee38464YesCredit/Debit Card, Purchase Order, Square
65
3/30/2020 1:00:46
Architectural Plastics, Inc.
BlakeMiremontblake@archplastics.com707-782-850004000Fully assembled1299 N McDowell Blvd.PetalumaCalifornia94954YesCredit/Debit Card, Purchase Order, Check, Wire, ACH
66
3/30/2020 8:31:18
Ty Fulfillment Services Inc.
MiguelGaitan
mgaitan@tyfulfillmentservicesinc.com
26223733977100300Kit form8009 49th AvenueKenoshaWisconsin53142YesCredit/Debit Card, Purchase Order
67
3/30/2020 9:34:50NUS, Inc.MariaMorenoMaria@nusinc.us7855812900100100Fully assembled2140 west beoadwayMesaArizona85202YesCredit/Debit Card, Purchase Order, Check
68
3/30/2020 9:53:46
Liftline Capital LLC dba Stencil Ease
JimRandolphjimr@stencilease.com847224625101500Either/Both7 Center Rd WOld SaybrookConnecticut06475YesCredit/Debit Card, PayPal, Purchase Order
69
3/30/2020 9:57:38Revolution FurnishingsGregBettencourtGreg@revfurn.com603669928001000Either/Both9050 S Willow StManchesterNew Hampshire03103YesCredit/Debit Card, Purchase Order, Photo of a check
70
3/30/2020 10:09:00HM GraphicsDanSoltysiakDaniels@hmgraphics.com414-615-275010010000Fully assembled7840 W Hicks StMilwaukeeWisconsin53219YesCredit/Debit Card, PayPal, Purchase Order, Wire Transfer
71
3/30/2020 10:27:46Creative FoamJamesSteinjrstein@creativefoam.com810-241-96622000040000Fully assembled300 N AlloyFentonMichigan48430YesCredit/Debit Card, Purchase Order
72
3/30/2020 11:09:44Firebolt Group IncBrian Sciackitano
brian.sciackitano@firebolt-group.com
248-624-8880 xt 104 / Mobile 219-313-3533
10001000Fully assembled28059 Center Oaks CtWixomMichigan48393-3347YesCredit/Debit Card, Purchase Order, ACH
73
3/30/2020 12:06:06Spark Services LLCLauraNogajLauraNogaj@gmail.com407-341-391410001000Fully assembled
960 Starkey Road Unit 9505
LargoFlorida33771YesCredit/Debit Card, PayPal, Purchase Order
74
3/30/2020 12:07:47Bardes Products, IncMaryStruppmstrupp@bardes.com414-759-35380500Fully assembled5245 W Clinton AveMilwaukeeWisconsin53223YesCredit/Debit Card, Purchase Order
75
3/30/2020 12:40:12LSI Graphics, LLCMasonEzzellmason@lsigraphics.com90123357030100Fully assembled2950 Brother BlvdMemphisTennessee38133YesCredit/Debit Card, PayPal
76
3/30/2020 12:52:03Champion GasketNathanDubuc
nathan@championgasket.com
2489213015050Either/Both3225 Haggerty Road
Commerce Township
Michigan48390YesCredit/Debit Card, Purchase Order
77
3/30/2020 13:08:13Laney CollegeMarkMartinmarkmartin@peralta.edu65024877281100Fully assembled900 Fallon St.OaklandCalifornia94618NoPayPal, Purchase Order
78
3/30/2020 13:24:42Prink MadeGarrettStaples
garrett.staples@prinkmade.com
5419147018500500Fully assembled
7911 Northeast 33rd Drive
PortlandOregon97211YesCredit/Debit Card, Purchase Order
79
3/30/2020 13:27:34
National Upholstery Inc. (NUS, Inc)
MariaMorenoInfo@nusinc.us785.581.2900100500Either/Both2140 west broadway MesaArizona85202YesCredit/Debit Card, Purchase Order, Pre pay, check
80
3/30/2020 13:30:04U.S. Automation, Inc.Dean Mouradiandean@usautocorp.com41473282001500025000Fully assembled21360 Gateway CtBrookfieldWisconsin53045YesCredit/Debit Card, PayPal, Purchase Order
81
3/30/2020 14:29:59
University of Hawaii at Manoa
FrancesZhuzhu@higp.hawaii.edu1913777959501Kit form1680 East-West RoadHonoluluHawaii96822YesPayPal
82
3/30/2020 14:56:11HEXA ContainmentJoshRawson
Josh.rawson@hexacontainment.com
225-828-76055000500Fully assembled709 S. 16th StreetLa PorteTexas77571YesCredit/Debit Card
83
3/30/2020 15:55:29sagree singhsagreesinghit@purplerain.co.za+2782318513301000Kit form1 Sundew RoadDurbanOutside of the USA4000NoPurchase Order, Bank Transfer
84
3/30/2020 16:38:19Knowhow shopJoeSongJoe@knowhowshopla.com 91395277530100Fully assembled6019 Echo St. Los AngelesCalifornia90042NoCredit/Debit Card, PayPal
85
3/30/2020 18:39:44Diamond textiles INC RichardDiamond
Sales@richarddiamond1.com
214-228-33240.2150Fully assembled
18484 Preston rd suite 102
DallasTexas75252YesCredit/Debit Card
86
3/30/2020 19:46:17Cyberia LTDAustinOwensaustin@cyberialtd.org31783550550250Either/Both
6800 East 30th Street, Suite OS500
IndianapolisIndiana46219YesCredit/Debit Card, PayPal
87
3/30/2020 21:06:45
Ron Vance Custom Projects
RonVanceron.bass.biker@gmail.com31033920620100Fully assembled1520 Ocean Park BlvdSanta MonicaCalifornia90405
Currently not set up to ship, but willing to. Currently plan on delivery in Greater Los Angeles area
PayPal
88
3/31/2020 7:53:19Wellborn Cabinet Inc.ShadrackMcGillsmcgill@wellborn.com2563547151010000Either/Both38669 Hwy. 77AshlandAlabama36251YesCredit/Debit Card, PayPal, Purchase Order
89
3/31/2020 8:08:29Walter Drake Inc.JosephFeigenjfeigen@walterdrake.com413-536-54632502500Fully assembled85 Sargeant StreetHolyokeMassachusetts01040YesPurchase Order
90
3/31/2020 8:22:09ThysseDeanBottdean@thysse.com608-301-7505050Fully assembled
281 West Netherwood Street
OregonWisconsin53575YesCredit/Debit Card, Purchase Order
91
3/31/2020 8:37:48
Precision Quality Systems
StephanieButeroSbutero.pqs@gmail.com715456911508000Fully assembled4515 Robin RdEau ClaireWisconsin54703USPurchase Order
92
3/31/2020 9:08:55
Eagle Gasket & Packing
WadeGaddiswade@eaglegasket.com28135791490200Fully assembled1110 Ulrich RdTomballTexas77375YesCredit/Debit Card, PayPal, Purchase Order
93
3/31/2020 9:25:29personalized expertsthomassouza
personalizedexperts@outlook.com
5613627015501500Either/Both943 Clint Moore RdBOCA RATONFlorida33487YesCredit/Debit Card
94
3/31/2020 10:52:35Mi5 Print and DigitalAndreMeurer
andre.meurer@mi5print.com
905-848-1550 x 2395001000Fully assembled1550 Caterpillar RoadTorontoOutside of the USAL4X1E7YesCredit/Debit Card, Purchase Order
95
3/31/2020 11:30:15
Siegfried Consultants LLC
STEVESIEGFRIED
steve.siegfried@emerson.com
5862451225250250Fully assembled535 Mary Ellen RdRochester HillsMichigan48307-2533YesCredit/Debit Card, Purchase Order
96
3/31/2020 11:48:11
FASTSIGNS of West Babylon
BryanSchwartz
Bryan.schwartz@fastsigns.com
16319433460500500Either/Both46 kean stWest Babylon New York11704YesCredit/Debit Card, PayPal, Venmo. Cash app. Quick pay.
97
3/31/2020 13:43:54Else servicesKAVINELANGOVAN
info.elseservices@gmail.com
0902 575 15472020Fully assembled
1/131/1D,SRI GANESA PLAZA , NALLIPALAYAM(POST)
NAMAKKALOutside of the USA637003NoPayPal, Purchase Order
98
3/31/2020 13:45:43Photodon, LLCDonBaschdonb@photodon.com2319463388200500Fully assembled
1517 Northern Star Dr, Suite A
Traverse CityMichigan49696YesCredit/Debit Card, PayPal, Purchase Order
99
3/31/2020 13:46:50Rainier IndustriesMattCutchinmattc@rainier.com4259811210500700Either/Both18375 Olympic Ave STukwilaWashington98188YesCredit/Debit Card, Purchase Order
100
3/31/2020 14:09:52Demco, Inc.KrisSnowcontracts@demco.com86655890680500Fully assembled4810 Forest Run Rd.MadisonWisconsin53704YesCredit/Debit Card, Purchase Order