VENDOR REGISTRATION QUESTIONNAIRE (VRQ)

Instructions

Please complete all sections of this form before submitting
You can only submit once
All documents to be attached must be clear and legible
Submit the most recent copies of the requested documents except otherwise state
All enquiries regarding the registration should be mailed to: procurement@ccsimpact.org
This registration portal closes on 30 August, 2021 by 4om

Company Name

Head Office Address

Abuja Office Address ( if different from Head Office )

RC Number (As indicated on registration certificate)

Date of registration (As indicated on registration certificate)

Contact Person 1

Official Email Address 1

Official Telephone 1

Cell Phone 1

Contact Person 2

Official Email Address 2

Official Telephone 2

Cell Phone 2

INDUSTRY

Briefly describe your business (e.g. printing and publishing, travel logistics etc.)

Bank Name

Account Number

NUBAN Account Number

Tax Identification Number (TIN)

Do you have an official Printed, Pre-numbered and Verifiable Invoice

Do you have official receipts

Do you have official Way bill/ Delivery Note

Name of Accountant

Telephone number of Accountant

Please provide full names of up to 2 of your current directors

Do you have any FORMAL links with another company?

if YES please state name of company and explain relationship

Please give details of your 2 MOST VALUABLE current customers

CUSTOMER 1

Company Name

industry

CONTACT NAME

CONTACT EMAIL

CONTACT TELEPHONE

CUSTOMER 2

company name

INDUSTRY

CONTACT NAME

CONTACT EMAIL

CONTACT TELEPHONE

Are you accredited by any relevant regulatory agency (NAFDAC,APCON, COREN, SON, NCC, etc.)?

Do you use your own FLEET or THAT OF a 3rd party for deliveries? If 3rd party, please give details below

Carrier Name 1

Carrier Name 2

Carrier Name 3

Do you own your own facility or you co-share

Are you willing to accept orders for delivery to other states?

DO you fixed price list with us for at least 6 months?

ARE YOU WILLING TO PROVIDE REPORTS OF THE FOLLOWING (ON REQUEST):

Orders outstanding?

Orders placed?

Deliveries made?

Are you prepared to offer us guaranteed discounts?

Please attach copies of the following documents (tick as applicable)

Company Registration Number (RC, CAC) Tax Clearance Certificate (TCC) Tax Identification Number (TIN) Company Profile Audit Reports of last 2 years Copy of Cancelled Cheque Book/Bank Reference Letter Other relevant documents

Select multiple documents to upload as required

Your Name

Position held in organization

Are you the authorized personnel to make this commitment on behalf of your organization

Vendor Registration

VENDOR REGISTRATION QUESTIONNAIRE (VRQ)

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