ILIGAN LIGHT AND POWER, INC.

___________________________________________________________________________________________

SUPPLIER / CONTRACTOR
ACCREDITATION FORMS
Supplier / Contractor
________________________________________________
Supplier Code
________________________________________________
Address
________________________________________________
Contact Person
________________________________________________
Telephone / Fax No.
________________________________________________

___________________________________________________________________________________________

The Procurement Section needs to determine whether the vendor above met your best
expectations as it relates to services performed as authorized by the Bids & Awards
Committee. The purpose of this evaluation is to measure vendor performance and user
satisfaction. Your response will allow us to determine whether or not to renew transaction and
services with said vendor.

*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE
 Procurement Section

Supplier’s Information Sheet

(CONFIDENTIAL)

1. Business Name: __________________________________________________________

2. Business Address: (as reflected in BIR Registration) ________________________________________
_______________________________________________________________________________________
2.a. Business Style or Nature of Business : ________________________________________
3. Telephone No. : ________________________ Fax No. ___________________________
4. Form of Organization: Single Ownership Partnership Corporation
5. Date Organized ___________________________________________________________
6. Tax Identification Number (TIN) : ______________________________________________
6.a. Tax Status : _____________________________________________________________

7. Company Officers/Authorized Representatives to deal with ILPI:

Name Address Contact No. Email
______________________ ___________________ _______________ _______________
______________________ ___________________ _______________ _______________

8. E-MAIL ADDRESS:
__________________________________________________________________________
*VERY IMPORTANT (Official email address of the company/store or Sales dept. where our Request for Quotation will be sent.)

9. Bank Credit Facilities:

Name of Bank Address Type of Account
_______________________ ___________________________
________________
_______________________ ___________________________
________________

10. What product lines do you carry? Please furnish us a separate list of your product lines

*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE
and quantity you can deliver to ILPI.
__________________________________________________________________________
__________________________________________________________________________

11. Please list the product/brands which you are a manufacturer of, or a duly appointed
distributor or exclusive distributor for.
Product/Commodity Local/Foreign Principal Company
_________________________________
_____________________________________
_________________________________
_____________________________________
_________________________________
_____________________________________
_________________________________
_____________________________________

12. Please note down financial information.

Annual Sales Total Assets Capitalization
Last Year __________________ _________________
___________________ Year Before Last __________________
_________________ ___________________

13. Please list down 5 major satisfied large customers.

Name of Company Address Contact Person
________________________ ____________________
_____________________
________________________ ____________________
_____________________
________________________ ____________________
_____________________
*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE
 ________________________ ____________________
_____________________
________________________ ____________________
_____________________

14. How many employees do you have? Are your employees unionized? _______________

Name and Signature: _____________________________________________________

Official Designation : _____________________________________________________
Date : ______________________
__________________________________________________________________________
Remarks (For ILPI Use)

*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE
SELF-DECLARATION
I, the undersigned, declare that:
(a) Our Company is not involved in any fraudulent or corrupt activities and has
not been in the past, and is not currently under investigation for any such
activities which would render our company unsuitable for business dealing
with ILPI; and
(b) Our Company is not currently removed, invalidated or suspended by any
government agencies in the Philippines.

Name and Signature: _____________________________________________________

Official Designation : _____________________________________________________
Date : ______________________

__________________________________________________________________________
Remarks (For ILPI Use)

*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE
List of Requirements for Supplier Accreditation

FOR MATERIALS ONLY:

O Copy of BIR Certificate of Registration

O Copy of DTI Registration (For Single Proprietorship)

O SEC Registration (For Partnership & Corporation)

O Copy of VAT or Non-VAT Registration Certificate

O Copy of Business Permit/License for Current Year

O UPDATED List of Product Lines

O Authorized Distributor Certificate

O Certificate of Appointment as an Exclusive Distributor

And/Or YOUR COMPANY PROFILE

*PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE (N/A) IF NOT APPLICABLE