CHASE BANK SUPPLIER PRE-QUALIFICATION FORM PLEASE FILL COMPLETE DETAILS 1.COMPANY NAME: 2: TYPE OF COMPANY REGISTRATION: (Please tick where applicable) (a) Limited company (b) Partnership (c) Sole proprietorship (d)Others (Kindly state) 3. COMPANY REGISTRATION DATE: 4 COMPANY REGISTRATION NUMBER: 5. COMPANY PIN NUMBER: 6.COMPANY VAT NUMBER: 7. PHYSICAL ADDRESS: (Please indicate building, floor location, street) 8. POSTAL ADDRESS: 9: TELEPHONE NUMBERS: 10. EMAIL ADDRESS/WEBSITE: 11. NAMES OF CONTACT PERSON: 12.NAMES OF DIRECTORS/OWNERS 13.NATURE OF BUSINESS ACTIVITY: 14. NO. OF YEARS IN BUSINESS: 15. PREVIOUS YEAR FINANCIAL TURNOVER: 16. CURRENT FINANCIAL TURNOVER: ( Please indicate bank , branch and account number: 17: BANKING INFORMATION 18. CUSTOMER REFERENCES: ( Please mention five major clients and names of contact persons and telephone numbers of at least three references) (I) (ii) (iii) (iv) (v) 19. PROFESSIONAL MEMBERSHIPS AND CERTIFICATIONS: ( Please state any industry certified awards) 20. COMPANY AUDITORS: 21. STATUTORY BUSINESS DOCUMENTATION: (Please provide the below documents) Certificate of incorporation Memorandum and articles of association Certificate of registration/Partnership Deed/Trust Deed Current business license Audited accounts for the last two ( 2) years Current tax compliance certificate Form CR 12 Certificate of good conduct Insurance indemnities
CHASE BANK SUPPLIER PRE-QUALIFICATION FORM PLEASE FILL COMPLETE DETAILS 1.COMPANY NAME: 2: TYPE OF COMPANY REGISTRATION: (Please tick where applicable) (a) Limited company (b) Partnership (c) Sole proprietorship (d)Others (Kindly state) 3. COMPANY REGISTRATION DATE: 4 COMPANY REGISTRATION NUMBER: 5. COMPANY PIN NUMBER: 6.COMPANY VAT NUMBER: 7. PHYSICAL ADDRESS: (Please indicate building, floor location, street) 8. POSTAL ADDRESS: 9: TELEPHONE NUMBERS: 10. EMAIL ADDRESS/WEBSITE: 11. NAMES OF CONTACT PERSON: 12.NAMES OF DIRECTORS/OWNERS 13.NATURE OF BUSINESS ACTIVITY: 14. NO. OF YEARS IN BUSINESS: 15. PREVIOUS YEAR FINANCIAL TURNOVER: 16. CURRENT FINANCIAL TURNOVER: 17: BANKING INFORMATION ( Please indicate bank , branch and account number: 18. CUSTOMER REFERENCES: ( Please mention five major clients and names of contact persons and telephone numbers of at least three references) (I) (ii) (iii) (iv) (v) 19. PROFESSIONAL MEMBERSHIPS AND CERTIFICATIONS: ( Please state any industry certified awards) 20. COMPANY AUDITORS: 21. STATUTORY BUSINESS DOCUMENTATION: (Please provide the below documents) Certificate of incorporation Memorandum and articles of association Certificate of registration/Partnership Deed/Trust Deed Current business license Audited accounts for the last two ( 2) years Current tax compliance certificate Form CR 12 Certificate of good conduct Insurance indemnities