Vendor

Vendor Registration Form

Company Details

Name of Company*:

Address*:

City*:

State*:

Country*:

Pincode*:

Telephone No.*:

Fax No.*:

Email ID* :

Website*:

Conatct Person details

Conatact Person Name* :

Address*:

City*:

State*:

Country*:

Pincode*:

Phone:

Mobile*:

Email ID* :

Vendor Status

Vendor Status* :

Nature of Business:

Manufacturer
Authorized Agent
Trader
Consulting ferm
Any Other

Registration No*:

PAN No*:

GST No.:

SSI Registraton No.:

PF Registration No.(For Contractor):

ESI Registration No. (For Contractor):

Year Of Establishment*:

Types of Products

Certifications obtained (ISO, OHSAS)

I decalre that the information furnished above is true and correct to the best of my knowledge.

I Undertake to inform you at the earliest any change in details mentioned above.

Reference of three companies where supply is being done

Company 1*

Contact Person Name* :

Designation*:

Mobile No.*

Company 2

Contact Person Name :

Designation:

Mobile No.

Company 3

Contact Person Name :

Designation:

Mobile No.

Turn Over Of Last Three Year

Year1*:

Year2:

Year3:

Information of Dealer Network across Country / State

Information of Dealer Network across Country / State :

Detail of Main machinery and other Euipments with Capacity

Name ( Vendor representative)

Company Profile *: