EASTCAPE TRAINING CENTRE SUPPLIER DATABASE APPLICATION FORM THIS FORM MUST BE COMPLETED AND SUBMITTED TO: By Hand Post Eastcape Training Centre Eastcape Training Centre Security Office PO Box 14082 Spondo Street Sidwell Struandale Port Elizabeth Port Elizabeth 6061 TICK CHECKLIST: ALL APPLICABLE DOCUMENTS LISTED BELOW MUST BE ATTACHED TO ALL REGISTRATION FORMS CERTIFIED COPIES OF BUSINESS REGISTRATION CERTIFICATE VALID ORIGINAL SARS TAX COMPLIANCE CERTIFICATE VAT REGISTRATION CERTIFICATE (WHERE APPLICABLE) COMPANY PROFILE CERTIFIED ID COPIES OF ALL MEMBERS, OWNERS, DIRECTORS OR SHAREHOLDERS VALID ORIGINAL BBBEE RATING CERTIFICATE CANCELLED CHEQUE / LETTER FROM FINANCIAL INSTITUTE NOT OLDER THAN THREE MONTHS
1. BUSINESS PARTICULARS SECTION 1 1.1 REGISTERED NAME OF BUSINESS 1.2 BUSINESS TRADING NAME 1.3 POSTAL ADDRESS 1.4 PHYSICAL ADDRESS 1.5 TELEPHONE NUMBER 1.6 1.7 CELL NUMBER 1.8 1.9 CONTACT PERSON FOR CORRESPONDENCE 1.10 CONTACT PERSON FOR SALES DEPARTMENT
1.11 CONTACT PERSON FOR ACCOUNTS DEPARTMENT 2. BANKING DETAILS SECTION 2 BANKING INSTITUTION NAME BRANCH NAME TOWN/CITY BRANCH CODE BANK ACCOUNT NUMBER ACCOUNT HOLDERS NAME ACCOUNT TYPE (An Original Cancelled Cheque to be attached or a Bank Verification Letter not older than three months) 3. COMPANY CORE BUSINESS SECTION 3 PLEASE COMPLETE THE FOLLOWING WITH A SHORT SUMMARY OF YOUR CORE BUSINESS, KEY WORDS THAT BEST DESCRIBE YOUR BUSINESS OPERATIONS AND ANY SPECIALISATIONS OUR CORE BUSINESS IS: KEY WORDS: SPECIALISATIONS:
4. YOUR BUSINESS PROVIDES SERVICES/GOODS FOR (Please tick the applicable block/s) Maximum of Five (5) to be ticked SECTION 4 Other specified ACCOMMODATION AIRCONDITIONING SERVICES ATTORNEYS/LEGAL SERVICES BUILDING & CONSTRUCTION MACHINERY AND ACCESSORIES BUILDING EQUIPMENT AND MATERIALS CLEANING EQUIPMENT & SUPPLIES DEBT COLLECTION DOMESTIC GLASS EDITORIAL & DESIGN & GRAPHIC & FINE ARTS SERVICES ELECTRONIC COMPONENTS & SUPPLIES ENVIRONMENTAL SERVICES FIRE AND SAFETY EQUIPMENT & INSPECTIONS FLEET MAINTENANCE FLORISTS/GARDEN SERVICES FUEL & LUBRICANTS FURNITURE & FURNISHINGS INDUSTRIAL CLEANING SERVICES INFORMATION TECHNOLOGY CONSULTANTS LOCKSMITH SERVICES MACHINE EQUIPMENT & SUPPLIES MANAGEMENT & BUSINESS PROFESSIONALS & ADMINISTRATIVE SERVICES OFFICE EQUIPMENT & ACCESSORIES & SUPPLIES PAINT SUPPLIES PEST CONTROL SERVICES PLUMBING SANITARY WARE & CONSUMABLES PPE (OVERALLS & SAFETY SHOES, EAR PLUGS, SAFETY GOGGLES) PRINTING & PHOTOGRAPHIC & AUDIO & VISUAL EQUIPMENT & SUPPLIES SECURITY & SAFETY SERVICES SERVER MAINTENANCE SHEET METAL & PIPES (GALVANIZED) SMALL TOOLS AND EQUIPMENT STUDENT BOARDING ACCOMMODATION TELEPHONE / PABX MAINTENANCE AND SUPPLIES TOOL & STEEL EQUIPMENT TRANSPORT SERVICES VEHICLE HIRE VEHICLE SPARE PARTS WELDING SUPPLIES OTHER (please specify)
5. CERTIFICATION SECTION 5 I, THE UNDERSIGNED (NAME) CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION FORM IS CORRECT. I ACCEPT THAT ACTION MAY BE TAKEN AGAINST ME SHOULD THIS DECLARATION PROVE TO BE FALSE. ID NUMBER POSITION SIGNATURE DATE 6. FOR OFFICE USE ONLY SECTION 6 Name of Supplier: Registration Number: Documents Attached: ( ) Business Registration ( ) SARS Tax Compliance Certificate ( ) VAT Registration Certificate ( ) Company Profile ( ) ID of Owners ( ) BBBEE Certificate ( ) Cancelled Cheque / Bank Verification Letter Input By: Checked By: Approved By: Signature: Signature: Signature: Date: Date: Date: