La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 1 of 6

Please legibly accomplish in black or blue ink. Only ORIGINAL COPY allowed.

Business Name : ____________________________________________________________________________

Address (Main Office) : ____________________________________________________________________________

Address (Plant/Warehouse) : ____________________________________________________________________________

Tax Identification No. : ____________________________________________________________________________

SEC/CDA Reg. No. : ____________________________________________________________________________

Tel. Nos. : ____________________________________________________________________________

24 Hrs Hotline No. (if any) : ____________________________________________________________________________

Fax No. : ____________________________________________________________________________

E-Mail Address : ____________________________________________________________________________

Contact Person(s) (1) : __________________________________________ Mobile No.: _____________________

(2) : __________________________________________ Mobile No.: _____________________
(3) : __________________________________________ Mobile No.: _____________________

I. BUSINESS BACKGROUND

Form of Business: Corporation Sole Proprietor Partnership Others _____________________

Name of Owner/Stockholders: _______________________________________________________________________

___________________________________________________________________________________________________
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Years in Business: ___________ Date Business Started: ___________ Capitalization: _________________
Average Monthly Sales: Peso ____________________________ Volume _______________________________
No. of Personnel: Regular _________________________ Casual _______________________________
Company Site Status: Owned Leased Rented Others ______________
Nature of Business: Manufacturer Distributor Indentor
Trader Sub Contractor Others

Officers Designation Contact Details

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Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187
 La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 2 of 6

*Please legibly accomplish in black or blue ink only

II. PRODUCT LINE

Please indicate Systems Certification/s (e.g. ISO, HACCP, GMP, Exclusive Distributorship) if any:

Certificate Date
_______________________________________ ___________________________________
_______________________________________ ___________________________________
_______________________________________ ___________________________________
_______________________________________ ___________________________________
_______________________________________ ___________________________________

Raw Materials Packaging Materials Spare Parts/Machineries Other (please specify)

Type of Raw Materials/Ingredients/Packaging Materials Capacity/ Volume per Month

______________________________________________________ ___________________________________
______________________________________________________ ___________________________________
______________________________________________________ ___________________________________
______________________________________________________ ___________________________________
______________________________________________________ ___________________________________

1. What Company are you currently supplying:

La Filipina Uy Gongco Corporation
Advanced Agrisolutions Philippines, Inc.
Amigo Agro-Industrial Dev't. Corp
Amigo Logistics Corporation
Amigo Plaza Mall
Others: ________________________
Amigo Shipping Corporation
Amigo Terrace Hotel
Capiz Sugar Central Inc.
Daruma Transport System Inc.
Excel Farm Corporation
Mama Tina Pasta Company, Inc.
Mindanao Grain Processing Co., Inc.
Philippine Leading Infinite Logistics Inc.
Philippine Foremost Milling Corp.

2. What Company do you wish to supply other than the one indicated above?

La Filipina Uy Gongco Corporation
Advanced Agrisolutions Philippines, Inc.
Amigo Agro-Industrial Dev't. Corp.
Amigo Logistics Corporation
Amigo Plaza Mall
Others: ________________________
Amigo Shipping Corporation
Amigo Terrace Hotel
Capiz Sugar Central Inc.
Daruma Transport System Inc.
Excel Farm Corporation
Mama Tina Pasta Company, Inc.
Mindanao Grain Processing Co., Inc.
Philippine Leading Infinite Logistics Inc.
Philippine Foremost Milling Corp.

III. DELIVERY

1. In how many days can you deliver your product upon receipt of Procurement Order? ____________________________
2. What is your mode of delivery? Own Truck; No. of Units _____________ Trucking Service _________________
3. What credit terms can you extend? ______________________________________________________________________
4. What is the maximum credit amount you can extend based on the credit term indicated above? _______________________
5. What is your minimum purchase? (a) Amount Php ___________________ (b) Volume _________________________

*Please legibly accomplish in black or blue ink only

Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187
 La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 3 of 6

BANK & TRADE REFERENCES

Name of Bank & Branch
__________________________
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Account No.
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Contact Person & Contact Number
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Name of Bank & Branch
__________________________
__________________________
__________________________
__________________________
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Account No.
_________________________
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Contact Person & Contact Number
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IV. Vendor Accreditation Packet Includes:

a. LFPR-F-002b rev. 04 Vendor Information Sheet (Pages 1 to 3 hereof)
b. LFPR-F-002b rev. 04 Attachments 01 to 03: List of Documentation Requirement Per Vendor (Pages 4 to 6 hereof)
c. LFPR-VACL-001 Rev. 04 Rationale (Pages 1 to 9)
d. Conflict of Interest Certification and Disclosure (CICD)
e. Non-Disclosure Agreement (NDA) if applicable

The vendor acknowledges to uphold LFUG GOC core values in all its transaction with the La Filipina Uy Gongco Group
of Companies (LFUG GOC)

In this, the Vendor certifies:

 To comply with all rules and regulations on vendor accreditation effective and made known to the VENDOR at
the time of application. Notwithstanding the foregoing, to maintain its accreditation, the VENDOR shall comply
with subsequent rules and regulations promulgated by the VENDEE and made known to the VENDOR.”
 That the information contained herein and provided attachments are true and correct.
 To voluntarily report all conflicts of interest, related party transactions and information updates as part of
ensuring vendor information remains current.
 To uphold non-disclosure of Confidential information
 To uphold the LFUG GOC Zero Gift Policy
 Not to participate in any form of bribery for all LFUG GOC transactions
 The material and/or services provided conforms to relevant food safety and government regulation and any
change in present product declaration or process must be immediately relayed to LFUG GOC thru Procurement
(in writing) that may impact quality, food safety or business operations.

The Vendor also certifies that the vendor accreditation process, evaluation and Vendee Standard Terms &
Conditions as stated in this Accreditation Packet are understood and complied.

______________________________________ _____________________________________
Signature over Printed Name/Date Designation

Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187
 La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 4 of 6

Vendor Accreditation Rule:

The VENDOR shall comply with all rules and regulations on vendor accreditation effective and made known to the VENDOR at the time of
application. Notwithstanding the foregoing, to maintain its accreditation, the VENDOR shall comply with subsequent rules and regulations
promulgated by the VENDEE and made known to the VENDOR.”

Attachment 01: List of Accreditation Documents

I. Local Vendors

o Accomplished Vendor Information Sheet (VIS)

o Conflict of Interest Certification and Disclosure (CICD)

o Company Profile

o Location Map (Offices, Plants/Mills, Warehouse); please label each site properly

o Latest/Updated Business Permit (BP)

o BIR Form 2303 (BIR Certificate of Registration)

o DTI Registration (if Sole Proprietorship)

o SEC Certificate of Registration (for corporation)

o Articles of Incorporation (for corporation)

o Sample – Invoice (SI) (photocopy only)

o Sample – Official Receipt (OR) (photocopy only)

o Latest Audited Financial Statement (FS) (with BIR stamp receipt)

o Bank Certificate of Good Standing for the last 6 months (if Financial Statement is not available)

o Certified True Copy Exclusivity / Distributor Certification from Principal (if exclusive distributor/agent)

o Five (5) sets of Business Cards per individual (President, Account Officer)

o FOR EACH BRANCH: submission of separate and complete set of Vendor's Information Sheet, Business Permit
and BIR Form 2303 is required.

o If the applicant is a branch, it must submit (a) the branch documentation and (b) the main/head office
documentation of the company.

o List of Top Three Clients (Contact person and contact details)

o List of Top Three Vendors (Contact person and contact details)

o List of Top Three Banks (Contact person and contact details)

o Non-Disclosure / Non Circumvention Affidavit (depending on material or service)

Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187
 La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 5 of 6

o Certified True Copy of ISO Certification (FSSC, FSMS, QMS, HACCP, GMP,BRC) (if any)

 (Not a mandatory requirement but priority will be given for Companies with certifications or with system
implemented)

II. Additional Document per vendor type

a) Service Vendors: Contractor

i. Current Certificate of Accreditation from the pertinent accreditation board and/or license from a
government regulatory body under which the contractor’s work/service specialty falls: e.g. PCAB License
ii. Curriculum Vitae of the Project Managers
iii. List of Past and Ongoing Projects (in relation to the scope of specialty the Contractor is being qualified for)
(should include project owner, project location, and contact details)
iv. Availability and commitment of Contractor’s equipment to be used for projects under the work specialty the
contractor is being qualified for

b) Service Vendors: Manpower Provider

i. Clearance from National Labor Relation Commission
ii. Certificate of SSS Registration
iii. Certificate of DOLE Registration
iv. Certificate of PhilHealth Registration
v. Certificate of remittance from SSS which included number of regular employees
vi. If security agency, PNP License to Operate

c) Service Vendor: Calibration

i. Certification as Certified Calibrator (from Philippine Metrology Standards Testing and Quality)
ii. ISO17025 Certification

d) Service vendor: Testing Center

i. Certificate of Accreditation (Philippine Accreditation Board0
ii. ISO17025 Certification

e) Service Vendor: Pest Control

i. License as Pest Control Operator (of the Company and/or of the Pest Control Officer)
ii. Certificate of training for the technicians

Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187
 La Filipina Uy Gongco Group of Companies

Doc. No.: LFPR-F-002b Rev. No.: 04 Effective Date May 29, 2017
VENDOR INFORMATION SHEET Page 6 of 6

III. Foreign Vendor

 Accomplished Vendor Information Sheet (VIS)

 Company Profile
 Location Map (Offices, Plants/Mills, Warehouse); please label each site properly
 Certificate of Business Registration (at/of Principal Business Tax Registered Address)
 Certificate of Tax Registration (at/of Principal Business Tax Registered Address)
 Conflict of Interest Certification and Disclosure (CICD)

Main Office: Quarantine Road, Brgy. Progreso, Lapuz, Iloilo City, 5000 Philippines
Telephone No.: (033) 337-3394 / (033 )337-4286; Fax No.: (033)337-4008

Manila Office: Lots 2&3 Block 1, B.V. Romero Blvd., Manila Harbour Centre, Radial Road-10,
Vitas, Tondo, Manila, 1012 Philippines
Telephone No.: (632) 516-7362 Fax No.: (632) 516-7187