First Balfour

VENDOR INFORMATION SHEET

VIS Control No.: / (FPBB/Year/Unique No.) / Date of Application:
Name of Company:
Type of Business:
A. ( ) Single Proprietor / ( ) Partnership / ( ) Corporation / ( ) Joint Venture/Consortium
B. ( ) Manufacturer / ( ) Fabricator / ( ) Contractor / ( ) Services
( ) Importer / ( ) Distributor / ( ) Trader / ( ) Others ______
Vendor Data:
1.1 Business Details
Office Address / :
Telephone Nos. / : / Fax. Nos. / :
Plant / Warehouse / :
Telephone Nos. / : / Fax Nos. / :
E-mail / :
1.2 Date of Establishment / :
1.3 Capital / :
1.4 VAT Registry No. / :
1.5 Number of Employees

Admin. & Finance

/ Engineering & Estimating
Sales & Marketing /

Production

Q.A. / ESH / Field Services
1.6 Key Personnel: / Title
1.7 Main Products or Services and Origin
1.7.1
1.7.2
1.7.3
Credit Terms offered:
1.8 Name of Several major Customer(Use separate sheet if needed)
Customer’s Name / Item Supplied /
Specification
1.9 Banking References
1.91 Bank / :
Address / :
Tel / Fax No. / : / Contact Person :
1.9.2 Bank / :

Address

/ :
Tel / Fax No. / : / Contact Person :
1.10 Certification and/or Qualification
1.10.1 ISO Certificate
Registration No. / :
Date / :
1.10.2 Other Certificate/s and/or Qualification/s Received (Please attached photocopy of document if needed):
1.11 Facility
1.11.1 Buildings (Please indicate area for the listed facilities)
Office / : / Manufacturing / Plant / :
Warehouse / Yard / : / Other Area / :
Total Area / :
1.11.2 List of Equipment / Plant Owned (Use separate sheet if needed)
Equipment
/ Specification / Quantity
1.12 Required Submittals (Please check for submitted document & NA if not applicable)
( ) Company Information / ( ) DTI Registration
( ) List of completed / Served projects / ( ) BIR Registration
( ) Credit Facilities / Bank References / ( ) Business / Mayor’s Permit
( ) Copy of Exclusive Distributorship /

( ) Contractors License (PCAB License)

( ) Latest Audited Financial Statements / ( ) DENR Certificate
( ) Articles of Incorporation / ( ) Truck Worthiness Certificate
( ) SEC Registration / ( ) Customs Brokerage License
( ) Board Resolution of Signatories / / ( ) Litigation / Arbitration Records
( ) Secretary Certificate / ( ) DOLE – BWC Registration
( ) Latest SSS Remittance Record / ( ) Latest Philhealth Remittance Record
1.13 It is the Corporate Policy of the Contractor / Purchaser that no Subcontractor or Supplier shall make or give any reward, payment, commission or inducement to any Employee or Officer of the Contractor / Purchaser to secure any Order or in return for reductions in scope or services or for false payment certification t be made and should any request or inducement be discovered or requested the Subcontractor or Supplier shall immediately report this verbally or in writing to the President and CEO of the Contractor / Purchaser who will treat the matter strictest confidence and take the appropriate action. Failure to report any such incidence which is discovered at any later date may result in legal action and cancellation of this Agreement / Order and removal of the Subcontractor / Supplier from the Contractors register of approved Vendors meaning no further business between us maybe transacted.
Certified True and Correct:
Signature & Date over printed name
(Application must be signed by owner or officer whose signature is accepted by your bank institution.)

First Balfour, Inc.

Km 19 West Service RoadTelephone+ 632 791-4000

Brgy. Marcelo Green, Sucat,Fax No.+ 632 791-4002

Parañaque City