Source: World Vision

VENDOR REGISTRATION FORM

1. Name of Company:

2. Street Address: 3. P.O. Box and Mailing Address:

Postal Code: City:

Country:

4. Tel: 5. Fax:

6. Email Address of Contact Person: 7. WWW Address:

8. Contact Name and Title:

9. Parent Company (Full legal Name):

10. Subsidiaries, Associates and/or Overseas Representative(s) - (attach a List if necessary):

11. Type of Business (Mark one only):

Corporate/ Limited: Partnership: Other (specify):

12. Nature of Business:

Manufacturer: Authorised Agent: Trader: Consulting Company: Other (specify):

13. Year Established: 14. Number of Full-time Employees:

15. Licence no./State where registered: 16. VAT No./Tax ID:

17. Technical Documents available in:

English French Spanish Russian Arabic Chinese Other (specify) _________________

18. Working Languages:

English French Spanish Russian Arabic Chinese Other (specify) _________________

Section 2: Financial Information

19. Annual Value of Total Sales for the last 3 Years:

Year ______: USD___________ Year ______: USD___________ Year ______: USD___________

1
 Source: World Vision

20. Annual Value of Export Sales for the last 3 Years: Year ______: USD___________
Year ______: USD___________ Year ______: USD___________

21. Bank Name: Swift/BIC Address:

Address:

22. Bank Account Number: Account Name:

23. Please provide a copy of the company's most recent Annual or Audited Financial Report. If available, please provide Credit Rating by
Dun and Bradstreet or equivalent:
Section 3: Technical Capability and Information on Goods / Services Offered

24. Quality Assurance Certification (e.g. ISO 9000 or Equivalent) (please provide a Copy of your latest Certificate):

25. International Offices/Representation (Countries where the Company has local Offices/Representation):

26. For Goods only, do those offered for Supply conform to National/International Quality Standards?

Yes No

27. List below up to fifteen (15) of your core Goods/Services offered:

Code Description (one Line for each Item) National/International Quality Standard
to which Item conforms

2
 Source: World Vision

Section 4: Experience

28. Recent Contracts with International Aid Organisations and/or the United Nations:

Organisation: Value: Year: Goods/Services Supplied: Destination:

USD

USD

USD

USD

USD

29. To which Countries has your Company exported and/or managed Projects over the last 3 Years?

Section 5: Other

30. Please list any Disputes your Company has been involved in with Intl. Aid Organisations and/or UN Organisations over the last 3
Years:

31. List any National or International Trade or Professional Organisations of which your Company is a Member.

32. Certification:
I, the undersigned, hereby accept the basic General Conditions, a copy of which has been provided to me and warrant that the
information provided in this form is correct, and in the event of changes details will be provided as soon as possible:

Name Functional Title

Signature Date

NOTE: By completing this form it does not automatically mean you will be added to our Vendor Database. There will be a review and
an evaluation process that must take place first.

Please Mail completed form to:

(Name Organisation)

Attn: Purchasing Department

3
 Source: World Vision

INSTRUCTIONS FOR COMPLETION

1. Full name of company.

2. Full street address.

3. Full mailing address (including P.O. Box, if any).

4. Telephone number, including correct country and area codes.

5. Fax number, including country and area codes.

6. Email address of the person who should be contacted regarding Request for Quotes or other questions relating to your company.

7. WWW Address.

8. Provide name of person (including title) or department to who correspondence should be addressed.

9. Full legal name of parent company, if any.

10. Please provide, on a separate sheet if necessary names and addresses of all subsidiaries, associates and overseas representatives if
any.

11. Please tick one box. If the last box is ticked, please specify.

12. Please tick one box. If the last box is ticked, please specify. If the company is a manufacturer of some products and a trader/agent of
others, which they do not manufacture, both boxes should be ticked.

13. Indicate the year in which the organisation was established under the name shown in Item 1.

14. Indicate the total number of full-time personnel in the company.

15. Provide the license number under which the company is registered, or the State where it is registered.

16. Provide the VAT number or Tax ID of the company.

17. Please tick the boxes for which languages the company is able to provide technical documents. Please specify other languages.

18. Please tick the boxes for which languages the company is able to work in. Please specify other languages.

19. Provide the total annual sales for the organisation for the last 3 financial years in USD.

20. Provide the total export sales for the organisation for the last 3 financial years in USD.

21. Provide the full name, address and SWIFT address of the bank used by the company.

22. Provide the company's bank account number and the account name.

23. Please provide a copy of your most recent annual report or audited financial report. If available, provide a rating by Dun and
Bradstreet or equivalent (specify which).

24. List any Quality Assurance Certificates (e.g. ISO 9000 series) that have been issued to your company and provide a copy of the latest
certificates.

25. List all countries where the company has local offices or representation.

26. Indicate whether the company's products conform to national/international standards. If yes please attach copies of the certificates.

27. Please list up to 15 of the core goods/services offered. For each item, list the National/International Quality Standard to which it
conforms.

28. Enter the name(s) of International Aid or UN organisations, which your company has dealt with recently. Provide the value and the
year of the contract, the goods/services supplied and the country of destination of each contract. If you have had more than 7 of such
contracts, please attach a separate sheet indicating the others. Documentary evidence of such contracts is required, e.g. copies of purchase
orders. Organisations in the UN system are: UN; UNCTAD; UNEP; UNCHS (Habitat); UNICEF; UNDP; WFP; UNHCR; UNRWA;

4
 Source: World Vision

UNFPA; UNOPS; UNU; ILO; FAO; UNESCO; ICAO; WHO; WB; IMF; UPU; ITU; WMO; IMO; WTO; WIPO; IAPSO; IFAD;
UNIDO; IAEA; ITC; ECA; ECE; ECLAC; ESCAP; ESCWA.

29. List export markets, in particular, all developing countries to which your company has exported over the last 3 years.

30. List all disputes with International Aid or UN organisations, which your company has been involved in over the last 3 years. If more
space is required, please use a separate sheet.

31. Provide details of all national and international trade or professional organisations to which your company belongs.

32. Please read the enclosed General Conditions carefully, as signature of the form signifies acceptance. The form should be signed by
the person completing it and their name and title should be typed, along with the date.