3 Section Three - Vendor Details - nwdc.co.zanwdc.co.za/wp-content/uploads/2013/11/nwdc-vendor-form1.pdf · 3 Section Three - Vendor Details ... products and / or services you can

3 Section Three - Vendor DetailsThis section deals with general company information.

Fld. Data Description Data Supplied # Chars3 Company / Vendor Trade Name 30

4Company / Business Type (* see below) 1

5If Company / Business Type = 6 (Other) Please Specify 1

6 South-African Company? (Y/N) 1

7

If not South-African Company please specify country in which business is registered.

30

8 Postal Address 1 309 Postal Address 2 30

10 Postal Address 3 3011 Postal Address 4 412 Physical Address 1 3013 Physical Address 2 3014 Physical Address 3 3015 Physical Address 4 3016 Physical Address 5 30

Details for Contact Person 117 Person 1 - Name 2518 Person 1 – Home Telephone No 1619 Person 1 – Work Telephone No 1620 Person 1 – Cell No 1621 Person 1 – Fax No 1622 Person 1 – E-mail Address 40

Details for Contact Person 223 Person 2 - Name 2524 Person 2 – Home Telephone No 1625 Person 2 – Work Telephone No 1626 Person 2 – Cell No 1627 Person 2 – Fax No 1628 Person 2 – E-mail Address 40

Miscellaneous Company Info29 Company Registration No 20

Generated from MYSQL-database: V-Proc1_7

Fld. Data Description Data Supplied # Chars30 Company TAX No 1831 Company VAT No 18

32Company Tax Clearance Certificate No 18

33Tax Clearance Certificate Expiry Date Format --> YYYY/MM/DD[ ] 10

First Three Directors / Members ** see below)

34 Director 1 - Full Name 2535 Director 1 - Nationality 836 Director 1 – ID Number 1537 Director 1 – Contact Tel No 1638 Director 2 - Full Name 2539 Director 2 - Nationality 840 Director 2 – ID Number 1541 Director 2 – Contact Tel No 1642 Director 3 - Full Name 2543 Director 3 - Nationality 844 Director 3 – ID Number 1545 Director 3 – Contact Tel No 16

* - Company / Business Type Indicators: 1 = One Man Concern; 2 = Closed Corporation; 3 = Partnership; 4 = Private Company; 5 = Public Company; 6 = Other

** - Companies / Closed Corporations / Partnerships with more than three directors / members / partners MUST give the details of at least THREE persons.

4 Section Four – Vendor Representative DetailsIn each venture there are a few individuals who are to be the 'face' of said venture. These are the individuals who will (mainly) be dealing with the Corporation, negotiating business, signing contracts, delivering goods or collecting documents.

In order for the Corporation to positively identify such individuals when needed, please supply the requested information here.

You may supply details for up to 4 (four) persons for this purpose.

Fld. Data Description Data Supplied # Chars46 Representative 1 – Full Name 3047 File Name of Photo on CD (*** 50


Fld. Data Description Data Supplied # Charssee below)

48 Representative 2 – Full Name 30

49File Name of Photo on CD (*** see below) 50





Marking on Media Supplied (**** see below)

*** - Digital photographs of each representative must be supplied for each nominated representative. The photographs must preferably be frontal head-and-shoulders images , size 100mm x 150 mm would be best) in any of the following formats: .jpg, .jpeg, .bmp or .gif. In the table above please supply the name of the file containing the image for the named person. Photographic images may also be emailed to the Corporation as long as a full name is given for each attached image, thereby achieving the same as above.

**** - Please supply the exact text used to mark the media supplied.

5 Section Five – Vendor Banking DetailsIn order to facilitate ease of payment to you via Electronic Funds Transfer (EFT) please supply us with the details of the account into which you would prefer payment be made to you.

Fld. Data Description Data Supplied # Chars54 Account Name 3055 Bank / Branch 3056 Branch Code 857 Account Number 16

58Account Type (***** see below) 1

***** - Account types are: 1 = Current (Cheque); 2 = Savings; 3 = Transmission; 4 = Credit Card.

6 Section Six – Supply Category DetailsThis section is of utmost importance in this application. For the Corporation to know what products and / or services you can render, we need to classify your offerings in Categories and Sub-Categories. You can register for a maximum of THREE major categories and a


maximum of NINE sub-categories for each major category.

Please Note: Should you make use of the opportunity to define your own descriptions it must be borne in mind that the total of THREE major- and NINE minor categories can not be exceeded in total.

Fld. Data Description Data Supplied # Chars

59Major Category 1 (****** - see below) 5

60 Sub-Category 1.1 561 Sub-Category 1.2 562 Sub-Category 1.3 563 Sub-Category 1.4 564 Sub-Category 1.5 565 Sub-Category 1.6 566 Sub-Category 1.7 567 Sub-Category 1.8 568 Sub-Category 1.9 5


70 Sub-Category 2.1 571 Sub-Category 2.2 572 Sub-Category 2.3 573 Sub-Category 2.4 574 Sub-Category 2.5 575 Sub-Category 2.6 576 Sub-Category 2.7 577 Sub-Category 2.8 578 Sub-Category 2.9 5


80 Sub-Category 3.1 581 Sub-Category 3.2 582 Sub-Category 3.3 583 Sub-Category 3.4 584 Sub-Category 3.5 585 Sub-Category 3.6 586 Sub-Category 3.7 587 Sub-Category 3.8 5


Fld. Data Description Data Supplied # Chars88 Sub-Category 3.9 5

Opportunity to enter / add your own definitions below if needed

89Major Category Undefined 1 (******* see below) 5

90 Sub-Category Undefined 1 5









****** - APPENDIX A to this application shows currently defined Major and Sub-Categories. Select the descriptions most appropriate to the nature of your business. In Column 3 ('Data Supplied), only enter the CODE for the major- or sub-category. The descriptions in APPENDIX A are not needed. Repeat, enter only the code in the above table.

******* - Should you feel that an appropriate definition of the nature of your business and business- or service offerings are not to be found in APPENDIX A you may provide us with a description of your OWN creation. Should the Corporation see fit to add such a new item to it's Category / Sub-Category Database it will be done. However, the Corporation may decide to classify your Category / Sub-Category participation in an existing one.

7 Section Seven - Professional Body MembershipIf your business has a valid membership of a recognized professional body for your nature of business or profession, please give us the details here. You have the opportunity to enter your details of up to THREE of such bodies / organizations.

Fld. Data Description Data Supplied # Chars

99Professional Body 1 – Full Name 50

100 Official Abbreviation 1 20101 Your Membership Reference 1 20102 Professional Body 2 – Full 50



8 Section Eight – BEE Rating and Information. Please give us a much information about your BEE-rating, if any.

9 Section Nine – Declaration and Signature(s),

I, _____________________________the undersigned do declare? and

• that all details contained in this application to be the truth; • that I / We, in signing this application, wish to render services in good faith to the

Corporation. • that I / We understand that the supply of false information to the Corporation may lead to

the entity making this application be removed from the Approved Vendor list of the Corporation.

• that I / We, being the signatory(ies) to this application, are fully authorized to do so on behalf of the entity represented herein.


• that I / We consent to the NWDC conducting any search or inquiry into the affairs of the Vendor.

Signed on this _______ day of ____________ 20___ at ________________________ Name: _________________________ (Please Print) Deponent

I certify that this affidavit has been signed and sworn to / affirmed before me at ___________ on this________ day of_________ 20_____ by the deponent who acknowledges that:-

I. He/ she /they know/s and understand/s the contents of this affidavit;

II. He/ she/ they has/have no objection to taking the prescribed oath/affirmation; and III. He/she/they consider/s the prescribed oath to be binding on his/her/their

conscience.

and that he/she/they uttered the following words’’

‘’I swear that the contents of this affidavit are true, so help me God ‘’ ‘’ I truly affirm that the contents of this affidavit are true’’.

_______________________________________

COMMISSIONER OF OATHS

Full names:

Address:

Designation:

Area for which appointment is held:

Office held if appointment is ex-officio:

APPENDIX A

Supply Category Selection For the NWDC

The NWDC uses an automated system to select possible suppliers for an item or service it wishes to purchase according to different criteria. One of these is the division of the itinerary in categories, both MAJOR and MINOR.

IMPORTANT: The list provided is CLIENT SPECIFIC and may differ if applying for registration as a vendor to a different institution.

In accordance with Section 6 – Supply Category Details please select at least one MAJOR and one MINOR category from the list below. The order of precedence in the list is NOT sorted in any specific sequence. It is generated from a database and according to the Administrator's selected preferences in order to maintain allocated sequence numbers as a number permanently allocated to that specific category. In the appropriate spaces provided enter ONLY THE RELEVANT CATEGORY NUMBER according to your selection.

MAJOR CATEGORIES MINOR CATEGORIES Seq. No Description Seq. No Description M0001 Food and Beverage F0001 Perishable / Fresh Products F0002 Meat F0003 Alcoholic and Soft Drinks M0002 Office Equipment E0001 Furniture – All types. E0002 Stationary E0003 Training Aids and Devices E0004 Signs and Accessories E0005 Air- Conditioning – Sales,

Installation and Service M0003 Building Material B0001 All material for building construction. M0004 Uniforms / Clothing U0001 Corporate U0002 Field Dress U0003 Promotional U0004 Protective Clothing M0005 Electronic Equipment L0001 Computers - complete L0002 Computers - Parts L0003 Printers L0004 Facsimile Machines

MAJOR CATEGORIES MINOR CATEGORIES Seq. No Description Seq. No Description L0005 Computers - Laptops L006 Computer Software L007 Copiers L008 Monitors L009 Cameras M0006 Kitchen Equipment K0001 Kitchen Manufacturing K0002 Appliances K0003 Cutlery & Crockery M0007 Chemicals C0001 Sanitary & Cleaning Chemicals C0002 Industrial Chemicals C0003 Fuel, Oil And Lubricants MS001 Services & Consultancy S0001 Printed Matter S0002 Catering Equipment Hiring S0003 Catering - Food S0004 Cleaning S0005 Swimming Pool Maintenance S0006 Laundry S0007 Building Maintenance - Electrical S0008 Building Maintenance - Plumbing S0009 Building Maintenance - Steelworks S0010 Building Maintenance - Carpentry S0011 Maintenance - Grounds S0012 Maintenance - Roads S0013 Building - Construction S0014 Road - Construction S0015 Road - Maintenance S0016 Consultancy – Accountancy &

Auditing S0017 Consultancy – Information

Technology S0018 Consultancy – Structural / Building S0019 Accommodation S0020 Conference Facilities S0021 Telecommunication Services S0022 Advertising S0023 Marketing

MAJOR CATEGORIES MINOR CATEGORIES Seq. No Description Seq. No Description S0024 Travel Agency S0025 Maintenance - Vehicles S0026 Maintenance - Heavy Equipment S0027 Maintenance - General S0028 Fencing – Installation & Maintenance S0029 Training - IT S0030 Training - General S0031 Refuse Removal S0032 Security S0033 Marketing / Promotional S0034 Legal Fees S0035 Seminars and Workshops S0036 Wellness S0037 Health and Safety S0038 Transport Services S0039 Repairs Office Furniture S0040 Hire – Tent and Chairs S0041 Renovations & Refurbishment S0042 Paving S0043 Tiling S0044 Painting S0045 Partitioning Of Office S0046 Repairs Maintenance Building S0047 Repairs Air Conditioners S0048 Repairs Refrigerator S0049 Solar System – Lights\Geyser S0050 Valuation of Property S0051 Installation of Blinds S0052 Furniture Removal S0053 Carpet Cleaning S0054 Cleaning of Office Chairs S0055 Installation of Ceiling S0056 Car Wash S0057 Cold & Hot Mix Asphalt (Tar Rd) S0058 Concrete Block Paving

MAJOR CATEGORIES MINOR CATEGORIES Seq. No Description Seq. No Description S0059 Procurement Management S0060 Risk Management S0061 Feasibility Studies S0062 Security Access Control System S0063 Project Management S0064 Monitoring & Evaluations S0065 Skills Training & Development S0066 Quantity Surveyor S0067 Tender Advertising S0068 Roofing S0069 Bottled Mineral Water S0070 Elevator Services S0071 Toilet Paper Supply S0072 P.A. System Hire S0073 Graphic Design S0074 Web Design & Hosting S0075 Events Management & Conference S0076 Strategic Planning S0077 Policy Development S0078 Recruitment S0079 Human Resources Consulting S0080 Corporate Governance Consulting S0081 Rental – Photo Copiers S0082 Counseling S0083 Windscreen Repairs S0084 Locksmith S0085 Trellidors S0086 Glazing S0087 Septic Drainage/Removal M008 Tools / Maintenance Equipment G001 Gardening Tools G002 Loose Tools M009 Vehicles V001 Trucks V002 Trailers V003 Bakkies V004 Cars

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3 Section Three - Vendor Details - nwdc.co.zanwdc.co.za/wp-content/uploads/2013/11/nwdc-vendor-form1.pdf · 3 Section Three - Vendor Details ... products and / or services you can