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  • VENDOR's REGISTRATION FORM New Excel

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    The document appears to be a vendor registration form for a specialty company. It requests information such as the vendor name, contact details, registration numbers, area of specialty, and required documents for submission. The form also includes a checklist for the vendor to select the specialty category that their company deals with, such as medical, non-medical, laboratory, or pharmaceutical items.

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    VENDOR's REGISTRATION FORM new excel

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    The document appears to be a vendor registration form for a specialty company. It requests information such as the vendor name, contact details, registration numbers, area of specialty, and required documents for submission. The form also includes a checklist for the vendor to select the specialty category that their company deals with, such as medical, non-medical, laboratory, or pharmaceutical items.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    11 views2 pages

    VENDOR's REGISTRATION FORM New Excel

    Uploaded by

    hashim_716108627
    The document appears to be a vendor registration form for a specialty company. It requests information such as the vendor name, contact details, registration numbers, area of specialty, and required documents for submission. The form also includes a checklist for the vendor to select the specialty category that their company deals with, such as medical, non-medical, laboratory, or pharmaceutical items.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    VENDOR'S REGISTRATION FORM for SPECIALTY

    SERIAL NUMBER:

    VENDOR NAME:

    COMPANY'S EMAIL ADDRESS:

    LAND LINE: FAX NUMBER:

    VENDOR VAT REGISTRATION NO.

    COMERCIAL REGISTRATION NO.

    ADDRESS:

    BANK ACCOUNT NO:

    AREA MANAGER NAME: MOBILE NO.:

    EMAIL ADDRESS:

    REPRESENTATIVE NAME: MOBILE NO.:

    EMAIL ADDRESS:

    CREDIT LIMIT/ ‫الحد االئتماني‬


    ‫ يلتزم المورد بتحديد المبلغ (الحد اإلئتماني) الذي يُ ًمكن شركة رعاية من التعامل في حدوده‬:‫* خانة الزامية‬

    VENDOR MUST SUBMIT THE FOLLOWING DOCUMENTS

    COMPANY PROFILE
    COPY OF COMERCIAL REGITSRATION
    COPY OF VALUE ADDED TAX (VAT) REGISTRATION
    SFDA CERTIFICATE
    APPROVED AGENT FOR ANY PRODUCT IF ANY
    COPY OF IBAN NO.

    VENDOR'S AUTHORIZED PERSON APPROVED BY:

    NAME: SUPPLY CHAIN MGT DIRECTOR

    SIGNATURE:
    VENDOR'S REGISTRATION FORM for SPECIALTY
    CHECK THE SPECIALITY THAT YOUR COMPANY IS DEALING WITH
    Select CODE ITEM CATEGORY

    NON-MEDICAL ITEM
    0101 NON MEDICAL ITEM DISPOSABLE
    010401 DIETARY SUPPLIES
    010402 STATIONARY SUPPLIES
    010403 IT RELATED SUPPLIES
    010405 HOUSEKEEPING AND GUESS SERVICES SUPPLIES
    010407 OFFICE SUPPLIES
    0103 NON MEDICAL CAPITAL EQUIPMENT
    0105 NON MEDICAL INSTRUMENTS
    0106 GENERAL SERVICE CHARGES
    0106010100 SERVICE CHARGES- OUTSOURCING
    0106010100323 SERVICE CHARGES- USED CARTOON COLLECTION
    010601010033 REMOVAL , OF GARBAGE SERVICES
    010601010035 CAR RENTAL
    0106010100362 SPARE PARTS MAINTENANCE AND LABORS
    0106010100566 SERVICE CHARGE FOR PEST CONTROL
    0106010100585 SERVICE CHARGE FOR RENTAL AND LEASE
    010601010065 SERVICE CHARGE FOR INSURANCE
    0108 NON MEDICAL SPARE PARTS
    0109 RE-USABLE NON-MEDICAL ITEMS
    MAINTENANCE ITEMS
    0601
    MAINTENANCE DISPOSABLE
    0605
    0602 MAINTENANCE SPARE PARTS
    0604 MAINTENANCE INSTRUMENTS
    0607 MAINTENANCE CAPITAL EQUIPMENT
    0608 MAINTENANCE CONSTRUCTION
    0609 MAINTENANCE RENOVATION
    MEDICAL ITEM
    0201
    MEDICAL DISPOSABLES
    0203
    020318 MEDICAL IMPLANTS
    0202 CAPITAL EQUIPMENT MEDICAL
    MEDICAL INSTRUMENTS
    0204
    DENTAL INSTRUMENTS
    0205 BIOMEDICAL SPARE PARTS
    0206 MEDICAL SERVICES CHARGES
    0207 MEDICAL REUSABLE ITEMS
    LABORATORY ITEMS
    050101 CHEMISTRY SECTION DISPOSABLE
    050102 HEMATOLOGY SECTION DISPOSABLE
    050104 BLOOD BANK SECTION DISPOSABLE
    050105 MICROBIOLOGY SECTION DISPOSABLE
    050105 SEROLOGY SECTION DISPOSABLE
    050106 PHLEBITOMU SECTION DISPOSABLE
    0502 LABORATORY REAGENT
    0503
    0504 LABORATORY DISPOSABLE SUPPIES
    PHARMACEUTICAL
    PHARMACEUTICAL ITEMS (MEDICATIONS)

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