NAGOS PROJECTS LIMITED

Vendor Registration Form

Please provide all information provided in this form and attach all documents requested in the questionaire.
Part A - Proposed Vendor Details
1. Vendor details
Organisation name (trading name that appears on
your invoices):
Company Address

Legal status (business Name or Limited Company):

Primary services provided: 1
3
4
2. Additional Details
Contact name:

Designation

Work phone number: Work phone number:

Email address

Details of Directors

1. Name Address

2. Name Address

3. Name Address

Company Registration Number/Date

Tax Identification Number [TIN]
VAT Registration Number

Procurement Department 1 NPL-CP-VRF-0002-1A

 NAGOS PROJECTS LIMITED
Vendor Registration Form

Part B - List of Mandatory information to Provided by intending Vendors

Requirements Submitted Not Submitted

Duly Completed Vendor

Registration Form

Certificate of incorporation

Tax Clearance Certificate

VAT Registration Certficate
DPR Permit
Letter of Reference from bankers
Memorandum & Articles of Association

Declaration
I declare that
1. The information given in this application is true and correct
2. I am authorised to make this declaration on behalf of the organisation.
Full name Job title
Signature Date

For Official Use Only

Vendor Details Verified By.

Name Title Signature: Date

Comment:

Registration Approvel
Name Title Signature: Date

Approved: Not Approved

VENDOR NUMBER

Procurement Department 2 NPL-CP-VRF-0002-1A

 NAGOS PROJECTS LIMITED
Vendor Registration Form

Average Annual Turnover in NAIRA [NGN]

Average Annual Turnover in DOLLARA[USD]

VAT Registration Number

Bank Name

Bank Branch

Account Name [Same as Company Name]

Account Number USD

Account Number NGN
Sort Code
Routing Code/Number

Do you have written HSE Policy Statement

Do you hold a quality assurance certificate

Contact person of QHSE Personnel

Procurement Department 3 NPL-CP-VRF-0002-1A