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Vendor Registration

Vendor Type

Incorporated Companies
Sole Proprietorship

SUPPLIERS REGISTRATION/KYC FORM

This registration questionnaire is to be completed by prospective Suppliers who wish to supply materials and/or render services to Cruxstone. The information provided is strictly confidential and solely for the use of Cruxstone. Once this form is completed, please submit to the procurement representative.

Please answer every question. if the question does not apply to you, please write N/A. Where insufficient space is available for a complete response to any question, additional pages or brochure information may be attached to this document.

Supplier Information









Contact Person










List of Executive Directors

Name Responsibility


Supplier’s Banker







Purchase Order "PO" routing



Company Profile

(Please tick as appropriate and provide relevant document as necessary)


  1. Is your company a Member of a Group of holding companies?
    Yes No

  2. Does your Company have a valid insurance policy?
    Yes No

  3. Does your organization hold a recognized quality Management certification (e.g. ISO 9000 or equivalent)?
    Yes No


Details of Products/Services

Please provide a brief description of the products/services offered by your company (please attach brochure and/or product catalogue as applicable)



Nature of Business



  1. Manufacturer?
    Yes No

  2. Trader *?
    Yes No

  3. Authorized Agent/dealer *?
    Yes No

  4. Service Provider?
    Yes No


Other (pls. specify):

  • Certification from your principals that you are authorized to deal with their products or to act on their behalf.
  • In case of *, kindly. specify the original Equipment Manufacturer (OEM)
  • In case of service provider, kindly provide licenses or any other relevant document required to operate as this service provider.


OTHER DOCUMENTS TO BE SUBMITTED WITH THIS FORM

PLEASE FILL IN IF YOU HAVE SELECTED INCORPORATED COMPANIES:

Certificate of Incorporation

Company profile

Form C02

Form CO7

Memorandum and Articles of Association

Joint Venture agreement with joint venture partners (As applicable)

Evidence of having done similar work (eg Executed contracts of Purchase order etc)

Relevant valid Insurance policy/cover (As applicable)

VAT certificate

Audited financial statements for the last 3 years


OTHER DOCUMENTS TO BE SUBMITTED WITH THIS FORM

PLEASE FILL IN IF YOU HAVE SELECTED SOLE PROPRIETORSHIP:

Registration of Business Name

Company profile

Joint Venture agreement with joint venture partners (As applicable)

Evidence of having done similar work (e.g. Executed contracts of Purchase order etc)

Relevant valid Insurance policy/cover (As applicable)

VAT certificate

Audited financial statements for the last 3 years


Escalation Matrix

Details Level-1 Level-2 Level-3
Name
Designation
E-mail Address
Phone Number


Payment Terms :

Kindly state your payment terms. However, Payment terms would generally be agreed on per transaction basis (Cruxstone’s standard payment term is 30 days after delivery/job completion and receipt of invoices).


Notes :

Any change(s) in the above details should be communicated to Cruxstone within three weeks of effecting the changes.


The signatory on this Supplier registration form guarantees the trust and accuracy of all responses given herein and is an authorized representative of the company/supplier.


Information submitted and completed by :