Vendor’s Registration Application Form

To The Chief of Material Engineering HMT Limited PINJORE – 134101 Distt. Ambala Haryana 1. Name of the vendor:-

2. Works Head Office Branch Offfice

Telephone No Telephone No Telephone No

Fax No. Fax No. Fax No.

Mobile Mobile Mobile

email email email

Website

3. Person to Contact:-

Name Official Capacity Telephone No.

4.(i) Type of Organisation � Individual � Partnership � Joint Stock Co. � Co-operative

(ii) Particular of Registration. (iii) Sales Tax Registration No.--------------------------------- Excise Registration No--------------------------------------

4a. Manufacturing Range:-

5. Category of vendor:- � Manufacturer � Small Scale Industry (Pvt) � Small Scale Industry (Govt.)

� Medium /Large Scale Indusrty (Pvt) � Medium/Large Scale Industry (Govt.)

� Wholesaler/Dealer/Stockist � Foreign If Manufacture give following particulars

Duration for which factory in production

Production capacity per annum

Details of facilities for Quality Controls

Details of machines in operation

Nos. of skilled employees

Sources of material

6. Services in which you are interested to register with us

7. Are you on the list of approved vendors/contractor on DGS & D, Railway or Govt., undertaking? If so, give Regn. No., Date and items for which registered.(Copy of registration/ Rate contract may be furnished.)

7 a. List of your OE/clients 7 b. Whether company ISO holder or NOT 8. Have you ever been banned or removed from any of approved Govt. Contractor/Vendor? If so, give details

9. Financial Status:-

(a) Value of current Assests as on Date:-

(b) Value of current Liabilities as on Date:- Attached Balance Sheet for the last 3 Yrs.

(c) Value of total sales during the previous year:-

Value of Order in hand:-

Value of total capital employed:-

(d) Banker’s Name and Address

(e) Maximum Credit facility from your Banker.

Dully supported with Banker’s certificate Amount upto which supply can be made at one time:-

(f) Have you obtained Income Tax Certificate/If so, State No. and date and enclose a copy of the same showing details of Income Tax assessed Tax demanded and paid for the last 3 years

4. List of enclosures:- Catalogues, Technical Literatures, Price List etc.

5. Any special information:-

6. We agree to abide by the general terms and conditions of contract inforceby time to time in HMT Limited, Pinjore

8. I certify that the information’s supplied here in (including all pages attached) is correct. SIGNATURE

NAME

DESIGNATION

7. Evaluation of Vendors

PLACE Date

NOTE:- 1. Use additional sheets where space in the form is insufficient. 2. Incomplete applications may be ignored with out any further correspondence.