Vendor Registration Form

Date :

SECTION 1: VENDOR INFORMATION - Use this section to indicate your company name, addresses, primary telephone number, after hours telephone number, facsimile number, email address (confirmation and notification purposes), website address and contact name.

Name of the Company
(Full Legal name) :

Parent Company
(if any) :

Year of establishment :

Tin no:

CST no.:

Service tax no.:

PAN No.

Address:

City:

State:

Pin Code:

Telephone Number:

Fax Number:

Contact Person:

E-mail Address:

Web Address (URL):

SECTION 2: TYPE OF ORGANIZTION - Please check all applicable

Sole Proprietorship (One individual owner)	Dealer / Distributor
Partnership	Local Agent
SSI	Importer
Non-profit organization	Trader
Private limited company	Manufacturer
Public Limited Company	Contractor
Other (Specify)	Consultant

SECTION 3: PRODUCT AND SERVICE SELECTION CHECKLIST – This section lists services/products that your company may provide. Please review and check all applicable boxes for the appropriate classification.
Additionally you may include a brochure or letter detailing the services/products offered by your company. This will ensure your company is notified accordingly of all opportunities to bid.

SECTION 4: ANNUAL TURNOVER – Use this section to indicate the business volume (Rs. in Lacs) segment wise for last 3 years

Business Segment	2007-08	2008-09	2009-10
Company as a whole
Services Division

SECTION 5: EMPLOYEES – Use this section to indicate the size of the organization

Category of Employees	Total Strength	Utility Services Division
Non-Technical
Technical

SECTION 6: MAJOR CUSTOMERS – Use this section to list the major customers served in last 3 years

Name of the Customer	Year	Services offered	Contract Value (Rs)


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