Vendor / Supplier Accreditation Form

Company Name*

Company Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Company Email Address*

Company Contact Number*

1. General Information

1.1 Contact Information

Contact Name

Position/Designation in the company

Telephone Number

Fax Number

Contact E-mail Address

Postal Address

Street Address City State / Province / Region ZIP / Postal Code Country

1.2 Company Overview

Company Name

Company Trading Name (if applicable)

City/Country of Incorporation or Registration

Company Identification Number/Incorporation Number/Taxation Number

SEC or DTI Registration Date

Type of Legal Entity

Sole Proprietorship
Partnership
Corporation
Publicly Listed Company
Other

Other Legal Entity :

Main Fields of Business (Please mark all fields that apply to your company)

General Civil Contractor
Electrical Supplier
Electrical Contractor
Mechanical Contractor
Engineering Design
Solar Components Supplier
Design & Construction
Other

Other Field of Business

Registered Head Office Business Address or Principal Place of Business

Street Address City ZIP / Postal Code Country

Head Office Telephone Number

Head Office Email Address

Head Office Website Address

Postal Address for Local Project Office(if any and if different to Business Address above)

Street Address City ZIP / Postal Code Country

Postal Office Telephone Number

Postal Office Email Address

Postal Office Website Address

2. Company Details

2.1 Director/Partners

Provide details of the directors and/or partners of the company. Click the "+" sign if more than one.

Details of Directors and/or Partners

Name	Address	Nationality	Position

2.2 Shareholders/Owners

Provide details of all shareholders or owners of the company that hold at least 10% shares.

Details of Major Shareholders/Owners

Name	Address	Nationality	Percentage Shareholding

2.3 Join Venture Partners

If the company is for or part of a joint venture, the company should list in the table below all joint venture partners and each partner’s proposed percentage contribution to the work. Click the "+" if more than one.

List of Joint Venture Partners

Name	Percentage

3. Financial Information

3.1 General

Complete the form below identifying the party responsible for the company’s overall financial matters.

Details of Financial Responsibility

Name	Position	Phone Number	Email Address	Mailing Address

Complete the form below identifying the party who would be responsible for the financial queries, if different from above.

Details of Project Financial Contact

Name	Position	Phone Number	Email Address	Mailing Address

3.2 Banking

The company shall list all major banking institutions utilized by the company and shall be used to accept payments thru wire transfer or bank deposit. Click the "+" sign if more than one.

Details of Banking Institutions

Bank Institution	Bank Address	Account Name	Bank Account Number

3.3 Company Taxes

What is your tax qualification?

Vat Registered
Non-Vat Registered

What months mark your fiscal year?

Has your company properly fulfilled all past and present tax obligations? If not, please attached a detailed explanation.

3.4 Insurance

The applicant should provide details on insurance for current and proposed insurances relevant to their line of business.

Details of Insurances

Employer’s Liability and/or Workers Compensation (or similar cover)

Yes
No

Employer's Liability Details

Insurer	Broker	Limits Of Cover

Professional Indemnity / Errors and Omissions

Yes
No

Professional Indemnity Details

Insurer	Broker	Limits Of Cover

Product Liability

Yes
No

Product Liability Details

Insurer	Broker	Limits Of Cover

Protection and Indemnity

Yes
No

Protection and Indemnity Details

Insurer	Broker	Limits Of Cover

Automobile Liability

Yes
No

Automobile Liability Details

Insurer	Broker	Limits Of Cover

Other Insurance

Yes
No

Other Insurance Details

Insurer	Broker	Limits Of Cover

3.5 Certifications and Attachments

The company should attached copies all relevant contracting and/or engineering certifications and documents in the Philippines or elsewhere (if available).

Here is the List of Accreditation Requirements for Vendors/Suppliers :

Contractor Pre-qualification Form
Signed Non-Disclosure Agreement
Photocopy BIR 2303 Certificate of Registration
Company Profile
List of Clients
Photocopy of Sample of Official Receipt and Sales Invoice (ATP)
Photocopy of Sample of Statement of Account (ATP)
Photocopy of Current Business Permit
SEC Registration
Latest General Information Sheet
Latest Audited Financial Statement
Interim Financial Statement

Attach Files

Drop files here or

Accepted file types: jpeg, jpg, png, pdf, Max. file size: 50 MB, Max. files: 15.

(File size limit : 50MB, File Extensions : jpeg,jpg,png,pdf)

4. References

All applicants for applying for prequalification must complete the forms and respond to the questions in this section, and must sign the final page of this section.

4.1 List of References

The applicant shall complete the form below providing name and contract details for at least three (3) organizations for which you have performed work or provided materials within the last five years. Click the "+" sign to add more rows.

Reference Details

Name of Company	Contact Person	Position	Description of Work	Contract Value	Contract Dates	Was the work completed on time?(Y/N)

Confidential Agreement Terms and Conditions*

I agree to the company's terms and conditions as found in the Confidentiality Agreement

Click here to read the Confidentiality Agreement.

VENDOR/SUPPLIER ACCREDITATION FORM