Document No.

EXTERNAL PROVIDER’S ACCREDITATION

PUR.FRM.001 – 08 (03/21)
FORM

EXTERNAL PROVIDER INFORMATION : 

Business Name : Year Established :

VAT/TIN Number: TERM OF PAYMENT:

Business Address :

Plant Address :

Telephone Number : Fax Number :

Type of Business :

CONTACT PERSONS : 
Name Position Email Address

OWNERS / STOCKHOLDERS : 
Name Position Email Address

BANK REFERENCES :  PRIFOOD CORP. PREFERED BANKS: MBTC/RCBC/BDO

Name Branch Tel No. Account Number

Page 1 of 3
 Document No.
EXTERNAL PROVIDER’S ACCREDITATION
PUR.FRM.001 – 08 (03/21)
FORM

SUPPLIED MATERIALS / SERVICES : 

PLANT INFORMATION :
Type of Operation:

Number of Employees: Direct: Indirect: Total:

Plant Capacity: Plant Number of Shifts:

Equipment / Machineries Used : ( Use other sheet if necessary )

Research Facilities :

Technical Facilities :

Delivery / Handling Equipment :

CUSTOMER REFERENCES : ( USE OTHER SHEET IF NECESSARY )

Page 2 of 3
 Document No.
EXTERNAL PROVIDER’S ACCREDITATION
PUR.FRM.001 – 08 (03/21)
FORM

Company Name Contact Person Contact Number

Documents / Records Submitted (Please Check) : 

Business Registrations
□ Mayor’s Permit
□ DTI / SEC Registration
□ BIR-Certificate of Registration(Form 2303)
Optional(If Available)
□ Company Profile / Organizational Structure
□ Financial Statements
□ Dealership / Distributorship Agreement
□ PTR / PRC License, credentials for individual offering professional skills & services.
Recommendation: □ Passed □ Failed □ For Further Evaluation

Prepared by: Received by: Noted by: Noted by:

Name & Signature Alfonso B. Bolneo Jade Roger C. Pedroza Mary Ann C. Cubillan
(Supplier/Applicant) Purchasing Supervisor MMD Manager RDPM
Date Date Date Date

Creditor Code: _______________

Date Encoded: _______________

Page 3 of 3
 Document No.
EXTERNAL PROVIDER’S ACCREDITATION
PUR.FRM.001 – 08 (03/21)
FORM

Page 4 of 3