Vendor Registration Form
       
      Regn Date 28/01/2012  
           
    Section 1 : Company Details and General Information  
           
    1. Name of Company *    
         
           
    2. Address and Contact    
      Street1 *    
      Street2  
      Street3  
      City / Province *      
      Post Code *    
      State *      
      Country *    
      Telephone *    
      Fax *    
      Email *      
      WebSite *      
           
      Contact Person *      
      Landline *    
      Extension  
      Mobile No *    
           
    3. P. O. Box and Mailing Address [If different from above] *  
       
           
    4. Parent Company [Full Legal Name] : *  
       
           
    5. Provide a Listing of Subsidiaries, Associates and/or Overseas Representative[s] : *
       
         
           
    6. Type of Business [Check one only] :  
     
   
           
    7. List below, up to seven (7), of your core Goods/Services offered. *  
     
 
           
    8. Nature of Business: If you check “Authorized Agent or “Authorized Distributor”, please provide proof or certificate(s) from your manufacturer(s) that you are authorized to offer their products. (Please send hard copy to our mailing address) *  
     


Upload the Certification of Authorization(Pdf File)

 [Max File Size 2MB]
 
           
9. List of authorized Products / Brands
      Product / Brand1 *    
      Product / Brand2  
      Product / Brand3  
      Product / Brand4  
      Product / Brand5  
      Product / Brand6  
           
    10. Year Established : *  
           
           
    11. Number of full time employees *  
           
           
    12.      
      License No and Country where registered *    
      Tax/VAT ID Number *    
      Upload Trade/Industrial Licence-Pdf) *  [Max File Size 2MB] MANDATORY FIELD
  
           
    13. Technical Documents available in: (check all that apply)  
     
 
       
           
    14. Working Languages : (check all that apply)  
     
 
           
    Section 2: Financial Information  
           
    15. Annual Value of Total Sales for the last 3 Years In Millions: *
      Year   AED       (million)  
      Year   AED       (million)  
      Year   AED       (million)  
           
    16. Annual Value of Export Sales for the last 3 Years In Millions:
      Year   AED    
      Year   AED    
      Year   AED    
           
    17. Please give i) a listing of a minimum of three (3) reference sources for services rendered by your firm
within the last 12 months and ii) original of recommendation letter * 		 
    Please also indicate fax numbers and contact person for your reference sources so that the we can contact them as and when required.  
       
      Company 1  
      Name of Company *    
      Address *    
      Phone *    
      Fax Number *    
      Company 2  
      Name of Company *    
      Address *    
      Phone *    
      Fax Number *    
      Company 3  
      Name of Company *    
      Address *    
      Phone *    
      Fax Number *    
           
    Note: For security reasons and to complete the vendor registration, please send the following to our mailing address:.  
    Bank name, SWIFT/BIC address, Bank address, Bank account number, Account name.  
           
    Section 3: Technical Capability and Information on Goods / Services Offered  
           
    18. Quality Assurance Certification (e.g. ISO 9001/OHSAS -18001/Environment Safety ISO 14001) *  
     
 
           
    19. International Offices/Representation (Countries where the Company has local Offices/Representation): *
     
 
           
    Section 4: Experience    
           
    20. Please list recent contracts *    
     
  Year AED Organization Goods/Services Supplied Destination
1  
           
2  
           
3  
           
4  
           
5  
           
           
 
           
    Section 5: Other    
           
    21. Please list any current legal disputes in which your company may be involved.  
       
           
    22. List any national or International Trade or Professional Organisations of which your Company is a Member. *  
       
         
23. Acceptance of payment terms and other discounts *
Preferred Supplier Status