Section 1: General Information
1- Name of Company (Legal)
2-Address: District 3- Mailing address (if different)
VDC/ Ward No
Postal Code
Street
P.O. Box Number
Country
4- Telephone 5- Fax
6- Website 7- Mobile
8- Contact Name and Title: 9- Email:
10. Nature of f Business
Authorized Agent Manufacturer Trader
Contractor: Retailer Other:
1- 6-
Please list your core 2- 7-
goods/services/ works 3- 8-
offered: 4-
5-
11. Year of established 12. Number of full time staffs
12. Number of Branch 13. Location:
14. VAT/ PAN Number: 15. License no./State, where registered
16. Working Language: English Gujarati Other
17. Does your company have a Code of
Conduct?
18. Please provide a copy of the company's most recent Annual or Audited Financial
Report.
19. Does your company have CSR related policies in place – e.g. health and safety
policy, HR policy, staff policy, energy policy, climate policy or is a member of Global
Compact? Please state which policies
Section 2: Financial Information
20. Annual Value of Total Sales for the last 3 Years: (000) in NPR
Year NPR Year NPR Year
NPR
18. Annual Value of Export Sales for the last 3 Years: (000) in NPR
Year NPR Year NPR Year
NPR
21. Bank Name 22. A/C Name
23. A/C Number 24. Branch address
25. Swift code 26. Types of A/C
Payment term
Section 3: Technical Capability and Information on Goods / Services
Offered
27. Do you offer customers a secure, web-based ordering & tracking system? Yes
No
28. List of international quality assurance 1-
certification held by your company(a copy of 2-
each certificate shall be enclosed): 3-
Annex-16
29. List of local and national quality assurance 1-
certification held by your company (a copy of each 2-
certificate shall be enclosed): e.g. ISO 9000 or 3-
Equivalent
30. List below up to five (5) of your core Goods/Services offered:
National/International Quality
Description
SN Standard to which item
Brand/Manufacturer , Model
conforms
1
2
Section: 4- Experience
31. Recent Contracts with International Aid Organizations and/or the United Nations:
Organization: Value: NPR Year: Goods/Services Supplied: Destination:
32. To which Countries has your Company exported and/or managed Projects over the last 3
Years (in particular developing countries)?
33. Payment Terms: Agreed
Disagree If disagree, Please state your payment
terms:
WIN standard payment for supply, service and works contracts is 100% payment within 30
days after delivery of goods and upon receipt of contractors invoice and shipping
documents. Prepayment is in general only acceptable against a prepayment guarantee
covering the full amount of the prepayment.
34. CERTIFICATION:
I, the undersigned, hereby accept the basic Terms and Conditions, a copy of which has been
provided to me and warrant that the information provided in this form is correct, and in the
event of changes, details will be provided as soon as possible:
________________
Signature
Name
Designation
Date
NOTE: Completing this form it does not automatically mean suppliers will be added to our
Approved Supplier Database. The WVIN reviews and evaluates submissions and contacts
prospective suppliers as necessary.
