**: Person signing the Bid shall have the power of attorney given by the Bidder to be attached with the Bid Schedules. Bidder Information Form [The Bidder shall fill in this Form in accordance with the instructions indicated below. No alterations to its format shall be permitted and no substitutions shall be accepted.] Date: [insert date (as day, month and year) of Bid Submission] ICB No.: [insert number of bidding process] Alternative No.: [insert identification No if this is a Bid for an alternative] Page ________ of_ ______ pages 1. Name [insert legal name] Bidder’s Bidder’s 2. In case of JV, legal name of each member : [insert legal name of each member in JV] 3. actual or intended country of registration: [insert actual or intended country of Bidder’s registration] 4. year of registration: [insert year of registration] Bidder’s Bidder’s 5. Address in country of registration: [insert legal address in country of Bidder’s Bidder’s registration] 6. Authorized Representative Information Bidder’s Name: [insert Authorized Representative’s name] Address: [insert Authorized Representative’s Address] Telephone/Fax numbers: [insert Authorized Representative’s telephone/fax numbers] Email Address: [insert Authorized Representative’s email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] Articles of Incorporation (or equivalent documents of constitution or association), and/or documents of registration of the legal entity named above, in accordance with ITB 4.3.
**: Person signing the Bid shall have the power of attorney given by the Bidder to be attached with the Bid Schedules. Bidder Information Form [The Bidder shall fill in this Form in accordance with the instructions indicated below. No alterations to its format shall be permitted and no substitutions shall be accepted.] Date: [insert date (as day, month and year) of Bid Submission] ICB No.: [insert number of bidding process] Alternative No.: [insert identification No if this is a Bid for an alternative] Page ________ of_ ______ pages 1. Bidder’s Name [insert Bidder’s legal name] 2. In case of JV, legal name of each member : [insert legal name of each member in JV] 3. Bidder’s actual or intended country of registration: [insert actual or intended country of registration] 4. Bidder’s year of registration: [insert Bidder’s year of registration] 5. Bidder’s Address in country of registration: [insert Bidder’s legal address in country of registration] 6. Bidder’s Authorized Representative Information Name: [insert Authorized Representative’s name] Address: [insert Authorized Representative’s Address] Telephone/Fax numbers: [insert Authorized Representative’s telephone/fax numbers] Email Address: [insert Authorized Representative’s email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] Articles of Incorporation (or equivalent documents of constitution or association), and/or documents of registration of the legal entity named above, in accordance with ITB 4.3.
Goods-EN-Apr2015.docx