Vendor Request

Vendor Registration Form

Company details and General Infromation

Company Name (required)

E-mail Address (required)

Head Office Address (required)

Postal Code

City

Phone (required)

Fax

Email (required)

Website

Parent Company (Full legal name)

Subsidiaries, Associates and/or Overseas Representative(s) - (attach list if necessary)

Type of Business (mark one only) (required)
Corporate LimitedPartnershipOther (specify)

Nature of business (required)
ManufacturerAuthorised AgentTraderService ProviderOther (specify)

If you mark "Authorised Agent" or "Trader", please provide proof or certificate(s) from your manufacturer that you are authorized to offer their products

Year established

Number of Full-time Employees

Please attach a listing of reference sources for services rendered by your firm within the last 12 months. Please also indicate fax numbers and contact person for your reference sources.

Financial Information (Please attach a certified copy of recent balance sheet)

Annual Value of Total Sales for the last 3 years

Year

USD

Year

USD

Year

USD

Bank Name

Address

Bank Account Number

Technical Capability and Information on Goods/Services Offered

Quality Assurance Certificate (please provide a Copy of your latest Cetificate)

List below up to ten (10) of your Core Goods/Services offered Authorised agents and Traders must submit proof of certificate from manufacturers that they are authorized to offer the products listed.

Certification
I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes details will be provided as soon as possible.

Full Name

Functional Title

Signature

Date

IMPORTANT

Please note that your company will be automatically de-registered if you do not provide any response to tender invitations by returning the Acknowledgement Letter, which is attached to the Invitation to Bid/Request for Proposal, on three consecutive occasions.