Vendor Registration Form 
Section 1: Company Contact Details and General Information
1. Name of Company:		
2. Street Address:
	City:	Postal Code:	Country:	
3. Mailing Address and P.O. Box:		
4. Telephone Number: 		
5. Fax Number:		
6. Website:		
7a. Contact Name (for Bids):		
7b. Contact Title:		
7c. Contact email address:		
8a. Contact Name (for Contract signature, if different to point 7 above):		
8b. Contact Title:		
8c. Contact email address:		
9. Parent Company, if any (full legal name): 		
10. Principal subsidiaries, associates, and/or representative(s), if any:
	
11. Corporate Seat:		
Section 2: Company Profile
1. Type of business	(Corporate/Limited, Partnership, Private Firm, Family Business)
	
2. Nature of business:	(Manufacturer, Authorised Agent, General Trader, Consulting Firm)
	
3. List of authorized products		
4. Year established		
5. Number of full time employees		
6. License number and Country where registered:		
7. Tax / VAT ID Number:		

Section 3: Financial Information and Experience
1. Annual value of total turnover for the last three years: 	
2014		2015		2016		
2. Profit or loss for the last three years:	
2014		2015		2016		

3. Contracts of similar scale/volume during the last three years:	
Customer Name	Value (EUR)	Year	Goods and Associated Services Provided	Country	

					

4. Three (3) customer references:	
Company Name	Contact Name	Position	Contact email	Contact telephone	

					

Section 4: Technical Capacity and Information on Goods/Services offered
Description of core goods / services offered:	
1.	
2.	
3.	
4.	
5.	
6.	
7.	

2. Quality Assurance Certification Number:		
3. Membership of International Trade or Professional Organisations:		

Section 5: Banking details
1. Name of Bank:		
2. Account Number:		
3. Account Name: Must be in the name of the vendor		
4. BIC:		
5. IBAN:		

Corporate Stamp and Signature of
Authorized Representative of Contractor:

Name:…………………………………………………….

Signature:………………………………………………

Date:………………………………………………………