ORIGIN VENDOR

VENDOR REGISTRATION FORM

Company Name

Address

Business Address

Phone No *

Official Email *

Company website (if any)

Contact person name

Job Tile of the Contact Person

Email of the contact person *

International Office (if any):

Subsidiary/Associate Company (if any)

Names of the Owner/Principal Officers/CEO/Managerial Members

Name:

Position:

Date of Establishment

Number of full-time employee

Registration Information

Country of Registration

Year of Registration *

Trade Registration No/CAC No *

Value Added Tax (VAT) No

Bank Information

Bank Name

Account No.:

Account Currency

IBAN (if applicable)

Contract Capacity Statement

Company Financial Net worth/Capital Base

Credit Limit Willing to Offer

Payment Terms and Conditions

Delivery Terms and Conditions

Transportation & Logistics Support Available

I certify that all information above is true and correct to the best of my knowledge. The above information is given for the purpose of Origin Group, Rhema Project to verify and add us to their Vendor List. *

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VENDOR REGISTRATION FORM

Names of the Owner/Principal Officers/CEO/Managerial Members

Registration Information

Bank Information

Contract Capacity Statement