9 DIRECTORS PARTICULARS ... ⬠Bank Account No. ..... Certificate of Incorporation, PIN, VAT, Directors PINs and IDs, D
CORPORATE HEADQUARTERS ? Capitol Hill Towers, 6th Cathedral Road, NRB. 34530 - 00100, NRB 020 2728603/4 020 2961000, 020 2962000 @
[email protected] 1 www.korient.co.ke
Suppliers Data Form 1 Supplier’s name | ............................................................................................................................................................ 2 Certificate (of incorporation) No. | ........................................................................ Dated | .............................................
3 PIN No. |...........................................................................................................................................................................
4 VAT No. | ........................................................................................................................................................................... 5 Postal Address / Postal Code / Town | ............................................................................................................................... 6 Physical Address | .................................................................................... Street | .........................................................
7 Building | ......................................................................................................................................................................... 8 E Mail | ............................................................................................................................................ 9 DIRECTORS PARTICULARS NAME
ID No.
PIN No.
Tel No.
1| 2| 3| 4| 5|
⓾ Managers Name |............................................................................................................................................................ ⓫ Name Of Your Bankers | ..................................................................................................................................................
⓬ Bank Account No. | ..........................................................................................................................................................
⓭ Auditors | ........................................................................................................................................................................ ⓮ Describe the nature of business you are involved in | ....................................................................................................
............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... ⓯ LIST FIVE MAJOR CLIENTS AND THEIR PARTICULARS NAME
CONTACT PERSON
Tel No.
1| 2| 3| 4| 5|
ADM/SDF/002
⓰ Has your company ever been in a dispute with a client over supply of goods or services ? If yes give details | ............
............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... ⓱ Have you ever supplied goods or services to KOIL? If so indicate the type of goods/ services provided | ......................
............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... ⓲ Credit Terms | ..................................................................................................................................................................
............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... I certify that the information provided here above is to the best of my knowledge correct.. NAME
DESIGNATION
SIGNATURE / STAMP
DATE
PLEASE NOTE – attach a copy of the following documents Certificate of Incorporation, PIN, VAT, Directors PINs and IDs, Directors Passport Photos ,Articles and Memo of Association and a Letter of recommendation from your bankers.
ADM/SDF/002
