ANFLO MANAGEMENT & IAIYESTMENT CORPORATION

Oamosa Complex,Ianang, Davao CiV, Davao delSur,8000, Philippines

* APPLICATION FOR VENDOR ACCREDITATION
MH FOR GOODS AND SERVICES

PL.tcw,tr.hPtuNr.Rt.Mtu,*(/)@app.oF"*nebd.rhnLt/Adblrhksp.c6tto,applEaue Ata.<h &itid6l tla.s, if @ty.

O New O Renewal O Additional Ac.r.ditation Date Filed

A. GENERAL INFORMATION
R.girtc.€d N.me of th. Comp.ry Or. ot Burin.6r Op.r.tionr Si.n.d

Be.dOlfr.c A&r6t (fot b.anch) Contact No.

w.r*ou5c/Pl.ni Addre.t Conl.ct No.

E-m.ilAddr6t Ofikt lw.$.tte (itany)

Autho.iz.d Mrn ging Offf..r / Cont d No. Accounting/fln.nce Manager / Conte.t No. aranch Mrnagcr / Contact No.

Typ. ol aulin $ O.g.niznbn

E Sole Proprieto6hip O Partnership El corporation El othe6, please spec

l{.me oI Own.r (For Soh ProprictoRhlp)

Bo.td of Dlr€ctor'

l. 3 5.

z 6.

Prc.ident / Chiel Exe<uttuc Oftk€r

Chkrf Fin (i.lOffi(er

Chicf Oper.ting Ofltce.

Affilirt€d Comp.ni€. .hdlor Rebr€d &5in6r

Bu5iness Nam€ Percentage of Ownership

Othcr itent^.rvic6 off C.€d

P.rmits and Licehs€3

Typ€ of Permit Registration No. Date Issued &piration Date

Securities and Exchange Commission

Department oflrade and Indunry

glR Registration Outbound Conespondence No. (OCN)

Tar Identification No.

DOIE Cenifiote of Registration

I6temational Organization f or standardi:ation 0SO) Certif ied?

El Yer Please sp€cify 0 tto

 B. REGISTRATION AND UCENSES
V.ndo6 {o. On -tlh. Tr..ljetbn rd Non-.oult r Low V.h. Goods/S..vk .
O Mayo/Business Permit O S€C/DTI Cenificate of Registration O 8lR Cedficare of Registratio.
Pb.se bnng he odginal .opy of docunents br autl,enticati.n:
P.rnltr.nd Lk6G :

El DTI Cedficate of Registrarion - Slngh Prcp.Ltorshl9 El Eureau of Domestac Trade Cenificat€ of Regisration

O Articles of Incoeo.ation & 8y-Laws - CorDor.LoI Cl tnvironmental Compliance Cenificate

E Adcles ofPannership - P.rtn.E&-p El cenificate of DealeEhip or Dealership Agreement

O SEC Certificate of Registration E) Importers eermit

El Mayor/8usin€ss Permit E oistrioution ngreement

O DOIE Cenificate of Registrataon

El t testAudited Financialstatements whh ITR rtamped as

O Photocopy of unerpired Authority to Print
re(eived by 8lR
El Photocopy of Passbook and/or Bank Statements for the past El Photocopy of 8lR Permit to use Computerized ,lccounting System (CpS)
six (6) months for CAS genelated invoices/OR's, if applicable.
O Photo<opy of 8lR-rcgistered Sal€s/Gsh/Ch.r9e lrvoice and Collection
El 8lR Cenmed true copy of Cenificate of Regastration
Receipt - tor S.L ot Goods
O Photocopy of 8lR-registered Billing Statement and Official Receipt - FoI
El IN verification Slip
S.h o, S.rvk t
O Certificate of Tax tr(emptioo, if appli(.ble
T..hnk l:
E company Profile El I5o cenificate, if cenified
E F€rtilizer and Pesticide Authority Permivcenificat€ El Orher appropriate licenses/documents

Please tqcit heft.:_

C, FINANCES
a.nk lnlorm.rlon
Bank Name Acaount Offiae. and Co.t ct Numb€r

'A nodoE rn tquird ao oPCo a,, a..ourrt uiah tlE Grurpl dcF:itoty Oan* (e.9. Seur y Aaok) ,o htilitatc.uto-c6dlt F)n t nt on the ,tt rc
t tis.ctioa ol v.ndort ol high-y.lu. g@ds/scrvicq aDd on ah€ 7th PO tt rrs2ction of veldoB ol low-nlu. gods,/t rLic!f,
D.INTERVIEW AND OCULAR INSPECTION

* Nn of the accreditation process, ,/e thall conducl an intetview with the contact person/authorized rep.esmtative indi.ated on this fom and Gulat inspe.tion ol
yout stote, ditplay area, warehoute shop, and other facilities. Pleate signily your willingness to accommodate the team we will commission to conduct the intetuiew
and ocular insqction by signing the authoization tlip blow and reaum this duly acconplished forn with requircd infomatioa suppoding documents and sketch
of you. busineit establishment/t location.

AUTHORIZATION
To Whom It May Concern

This as to authodze the.epaesentative(s) of The Company to conduct an intervie* with the contact person/authodzed represemative and ocuhr inspction of our
store, display area, warehouse, shop, and oth€r facilhies.

For your guidance.

Authorired Officer

oesignation

I hereby certify that I am the authorized officer to malethis statement and that allthe information provided are true and accurate to th€ best of my knolvledge

Sign.ture der pnnt.d name

Designation
Date Accomp ished

l- Subnistion ol thit bon tquie dre attxhnent olccrtitled copis of.erlifr.at6 an dtunenb
2 lhe Conpany .6aves tlE ngh? to Eguest for additiotEl info,n a:oa or docunents n46saty to conplctc tE a.cEditatial yo.ctt.
,. the CMpany* l t@t inbdneobn tupplid flth srna eon6dcnrialry.
4 R6ult of etdrt. on shall b t ot lo tlE potaod.o,t *td throt gh Mi/.
5. Accdtaatioa *i b tcoci6d asy t*o (2) ra6.

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