Supplier Enlistment Form - CCG - V.001

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Add photograph

Supplier Enlistment Form of the owner


Crown Cement Concrete and Building Products Ltd. (1 X Passport)

04.09.2023
Date : ___________ To be used for : ■ Create Update Delete
Vendor Type : ■ Local Foreign One Time Category : Manufacturer ■ Trader ■ Service

Smart Gadgets & Trading


Name of the Organization : ___________________________________________________________________________
Suite # 1109/B, Level # 11, 69/71 Multiplan Centre, New Elephant Road, Dhaka-1205
Registered Address : _________________________________________________________________________________
Bangladesh
________________________________________________________________________ Country : __________________
01713160665
Phone (Mob‐1) : __________________ 01674731282
Phone (Mob‐2) : _____________________ Phone (Land) : ___________________
[email protected]
Email (Main) : ________________________ [email protected] Fax : _____________________
Email (Alt) : __________________________
Nayeem Bin Faiz
Contact Person : ________________________ Owner
Relation : __________________ 01674731282
Contact No. : ______________________

DSCC/280694/2019
Trade License No. : _____________________ 0008858980201
VAT No. : _____________________ 632411195387
TIN No. : _______________________

Payment Term : _____ Days (upon receipt of the ■ Goods/Service ■ Invoice ) BDT
Order Currency : _______________

Supply
Goods/Service Name/Type (in detail) : __________________________________________________________________
50,000,000.00 Years of Experience : ____________
Annual Appx. Revenue (BDT) : _______________ 10years Enlisted to Govt. : ■
Yes No
1. Tokyu Construction Co., LTD 2. Tahir Enterprise Ltd. 3. ACI
List your five major client(s) name (if any) : ________________________________________________________________
3. Safe Structual Engineering 4. BANBEIS 5. Popular Pharmaceuticals Ltd.
__________________________________________________________________________________________________
Do you have any of the following certification : ISO OHSAS Any other‐ please mention ___________________

Do you have any relative/s and/or friend/s working/worked with Crown Cement Group : Yes ■
No
If Yes please describe name, dept. and designation : _______________________________________________________

Please attach copy of following documents – a. Updated Trade License b. BIN Certificate c. TIN
TAXCertificate
Certificate d. NID (Owner)

SAP ID : _________________ (to be filled by buyers office only)

Signature of Supplier Recommended by Approved by


(with company seal) CCC&BPL
Crown Cement Group CCC&BPL
Crown Cement Group

You might also like