Doc No.

: PUR-F-08
Section A - Vendor/Contractor Registration/information
Page No. : 1 of 2
Form Rev No. : 00
(to be submitted by Vendor/Contractor on company letter head)
Eff. Date : 11.06.2014

COMPANY DETAILS
Name of Company / Firm

Material /Service Category

(for which prequalification is sought)

 Propriety  Partnership
Type of the company /organization
 Public Ltd.  Pvt. Ltd
(submit copy of Certificate of Incorporation/ /Shops &
Year of establishment establishment certificate)

 Manufacturer  Service Provider

Type of the operation
 Traders  Authorized Distributor
Registered as Small Scale (SSI) vendor
 YES  NO
(MSMED)
ISO certified  YES  NO
Foreign collaboration  YES  NO
Name:
Designation:
Key Contact Person
Mobile No.
Email ID:

CONTACT DETAILS
Address:

Address of Registered Office :

Phone No.
Fax No.
Address:

Address of Works/Manufacturing Location:

Phone No.
Fax No.

TAX REGISTRATION DETAILS

(Submit copy, if not submitted along with EOI/ITT response)
PAN Card No.
VAT Registration No.
CST Registration No.
Service Tax Registration No.
Any other applicable registration details
i.e. Provident Fund / Labour License etc.

Page 1 of 2
RTGS Details (As per format attached on company letter head)

BIDDER DECLARATION:
I confirm that I have read and understand the GGL Business Principles. I declare that I am in no way related to
/have any business relationships with any Employee of GGL or with an existing vendor/contractor of GGL.

Bidder Seal and Sign: Date:

Note: Please ensure that above declaration is true in all respect. In the event of it being found to be false in
any manner, GGL reserves the right for termination of any contract entered in with the Vendor/Contractor
OR black listing from the approved list of Vendor/Contractor without any Notice.

Page 2 of 2