VENDOR REGISTARTION FORM

Sl No Particular
1
Name of the company/Firm
2

Mailing address

Ph No

Fax no

(1)
(2)
(3)
(1)
(2)

E mail

6
7

Web site
Constitution of the firm
(tick against applicable)
Govt of India Undertaking
State Govt undertaking

Limited co
Pvt Ltd Co
Co Operative society
Partnership firm
Proprietor ship
Any other (specify)

9
10

11

Nature of business
(tick against applicable and
attach documentary
evidence for authorization)
Manufacturer
Agent
Distributor
Stockiest
Others
Year of establishment
Vendor Registration sought
under items (give category
code and description as per
published category list)

Quality systems practiced

(ISO 9001,14001,18001,etc)

CH-PUR-F-14(1)/16-11-2009

Proof of above shall be

12
13
14
15
16
17
18

19

20
20

attached
CST reg No
TIN no
Central Excise Reg No
PAN No
Service tax Regn No
PPF Regn No
SSI/NSIC Reg No
(Indicate for which item and
validity. Also please enclose
the copy of registration)
Details of Financial
position provided?
Please provide details as per Yes/No
annexure supported by
documentary evidences
Write up about technical Yes/No
competence provided?
Bankers reference

21

Client list as per format

Yes/No
attached?
22
List of major orders
successfully executed in the
last five years as per
Yes/No
format attached?
23
Details of registration with Yes/No
other PSUs as per format
and with copies of orders
24
Details of registration with Yes/No
other IREL units as per
format and with copies of
orders
25
Details of collaboration
(foreign/indigenous OR
financial/technical)
26
Name and designation of
official to be contacted
Certified that the information provided above is true.
26

Signature and seal

CH-PUR-F-14(1)/16-11-2009

LIST OF MAJOR CLIENTS/CUSTOMERS

(To be filled and submitted along with vendor registration form.)
Sl
No

Name and address of the

organization

CH-PUR-F-14(1)/16-11-2009

Names of contract

Total value of orders executed in last five years

LIST OF MAJOR CONTRACTS SUCCESFULLY COMPLETED

(Preferably in the last five years. To be filled and submitted along with vendor registration form. Also please attach
relevant order copy preferably with work/supply completion certificate.)
Sl
No

Name of contract

CH-PUR-F-14(1)/16-11-2009

Name and address of Reference for Contact Year of execution

the organization
(name and ph no)

Value

Status

CURRENT VALID VENDOR REGISTRATION WITH OTHER PSUs/IREL UNITS

(To be substantiated with relevant, acceptable documentary evidence. Also please indicate if you are already registered
with any other IREL units)
Sl
No

Name of organization Address

CH-PUR-F-14(1)/16-11-2009

Registered for (give details)

Validity of
registration

LIST OF MAJOR CONTRACTS SUCCESFULLY COMPLETED WITH OTHER IREL UNITS

(Preferably in the last five years. To be filled and submitted along with vendor registration form. Also please attach
relevant order copy preferably with work/supply completion certificate.)
Sl
No

Name of contract

CH-PUR-F-14(1)/16-11-2009

Name and address of Reference for Contact Year of execution

the organization
(name and ph no)

Value

Status

STATEMENT OF FINANCIAL COMPETENCE

(For three consecutive years ending the previous year on which the request for registration is made. The details are to
be furnished from left to right from the latest to backward. The statement shall accompany audited Profit and Loss
Account and Balance sheet for the relevant periods with relevant field highlighted)
Sl No
1
2
3
4
5
A
1
2
3
4
5
B
C
D
E

Period 1-specify
Land
Buildings
Machinery
Sundry Debtors
Other assets
ASSETS
Capital
Reserves
Long Term Loans
Sundry Creditors
Other liabilities
LIABILITY
PROFIT & LOSS
Turn over
PBT
PAT

CH-PUR-F-14(1)/16-11-2009

Period II specify

Period III-specify

STATEMENT OF TECHNICAL AND ORGANISATIONAL COMETENCE

(Please provide relevant information in brief including the details about the key personnels, human capital available,
infrastructure facilities, technical tie-ups,patents owned, awards and accolades received,etc)

CH-PUR-F-14(1)/16-11-2009