NEW SUPPLIER EVALUATION FORM

Application Date:

Company Name:

Company Registration Number:

Vat Registration Number:

Physical Address:

Postal Address:

Telephone:

Mobile:

Fax:

Other:

Shareholders:

Is your company BBBEE compliant?

If yes, what level of BBBEE compliance do you have? (Please attach latest certificate)

Latest Financial Statements Available?

Date of Latest Financial Statements:

Bank:

Branch:

Account Number:

Turnover per Annum:

Current Customers:

What products do you supply and where are they manufactured? (Please list all locations)

Current minimum production run quantity:

Minimum time needed between order and delivery:

Innovage Resources - Lichtenburg
BMS - Hendrina
Vogelstruiskraal - Rustenburg

Company Registration Documents:

Director’s I’D’s:

Vat Registration:

Tax Pin:

Proof of Address:

Bank Letter:

BBBEE Certificate:

Letter of Good Standing:

SUBMIT