<p> BAJRAWIA FACTORY Page 1 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Vender Application Form (CATEGORY)</p><p>Supply & Service Sub-categories: (Select the ones you are applying for)</p><p>SPL/SRV-TRL ( SPL/SRV MAIN HEADER )  SPL/SRV-XXX-01 (SPL/SRV SUB-CATEGORY)  SPL/SRV-XXX-02 (SPL/SRV SUB-CATEGORY)  SPL/SRV-XXX-03 (SPL/SRV SUB-CATEGORY)  SPL/SRV-XXX-04 (SPL/SRV SUB-CATEGORY)  SPL/SRV-XXX-05 (SPL/SRV SUB-CATEGORY) SPL/SRV-XXX-06 (SPL/SRV SUB-CATEGORY) </p><p>Company Name:</p><p>Reference no.</p><p>1. No changes to the format should be made with the exception of adding space for additional information. 2. Reference no should be included in the header of the file. 3. The completed application shall be submitted as a soft copy to: [email protected] and as a hard copy to the following address: Bajrawia Factory for Equipment Procurement Department Al-manshia, Block A, Building No. 1/22, KHARTOUM, SUDAN. Tel. No. : +249-183-286737 Fax No. : +249-183-286737 E-mail: [email protected]</p><p>Reminder: For hand delivery, retain this receipt for reference.</p><p>Receipt information</p><p>Receipt no :</p><p>Received by :</p><p>Date: : Applicants : Signature</p><p>COMPANY DETAILS BAJRAWIA FACTORY Page 2 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Company Name Registered Business Address Fax No.</p><p>Telephone Number</p><p>E:mail Address</p><p>Contact Name(s)</p><p>Contacts</p><p>Please attach the company memorandum and article of association approved from government authorities</p><p>GENERAL INFORMATION: Submit your company type: Years Under Country of Date of Type Tick ( √ ) Present Incorporation Incorporation Company Name Corporation Joint-Venture Subsidiary Individual Others (describe)</p><p>Provide certified true copies of Business License or Certificate of Incorporation.</p><p>Provide information on affiliated companies (provide attachment if space is insufficient): Affiliation (√)</p><p>Company & In Tel. & Fax Pare Subsidia In Others contact Middle no. nt ry Sudan Locations name Ease</p><p>Do you have any affiliated company? (Yes or No) -please provide as If you plan to, please provide detailed plan attachment- BAJRAWIA FACTORY Page 3 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Provide Parental Guarantee from each holding/principal/parent company.</p><p>Specify Major Financial Parameters: Authorized Capital (SDG) Paid-up Capital (SDG) Most Recent Last 1 Year Last 2 Years (Year: ) Year: (Year: ) Net Worth / Shareholder’s Funds (SDG) - Specify most recent and the previous 2 years. Turnover (SDG) - Specify most recent and the previous 2 years. Gross Profits (SDG) - Specify most recent and the previous 2 years.</p><p>Attach final accounts (audited) for the last three Attach any bank letters that demonstrate your financial capabilities Value added tax and Zakat authority release certificate</p><p>Specify Major Shareholders of the Company: Holdings Authorized No. Name Position percentage signatory (√) (%) 1 2 3 4 5 6 BAJRAWIA FACTORY Page 4 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Organization structure:</p><p>Chairman / President</p><p>CEO/MD/GM</p><p>Manager Manager Manager Manager Manager Name: Name: Name: Name: Name:</p><p>Notes:  The organization chart has to follow the above format as guideline. If your organization chart is more elaborated, please submit as an attachment. The resumes of key personnel have to be submitted as attachments.  Please attach the last endorsement last updated ones</p><p>HEALTH, SAFETY & ENVIRONMENT AND QUALITY ASSURANCE (SERVICE CONTRACTORS ONLY) </p><p>Specify the following Health Safety & Environment documents: No. YES( √ ) NO( √ ) Does your company have a written H. S. E / loss prevention 1 program? Does your company have an established, written H. S. E. 2 Policy? BAJRAWIA FACTORY Page 5 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Specify the following Quality Assurance documents: No. Quality Standard Is your company accredited to ISO 9001 or equivalent 1 standards? Specify which standard. Does your company have a written Quality Assurance 2 Manual in place? (YES/NO)</p><p>Provide copies of accreditation certificates. BAJRAWIA FACTORY Page 6 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>PAST EXPERIENCE:</p><p>Specify the details of works executed over the past five (5) years which related to the criteria you are applying for. Please provide supporting documents from your clients</p><p>In Sudan:</p><p>Contract Duration / Total Type of Completion No. reference (name Delivery contract Work Status (Y/N) and no.) Date value (SDG) 1 2 3</p><p>Outside Sudan:</p><p>Contract Duration / Total Type of Completion No. reference (name Delivery contract Work Status (Y/N) and no.) Date value (SDG) 1 2 3 BAJRAWIA FACTORY Page 7 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>SIGNATURE SHEET</p><p>I/We hereby certify that all the information and documents furnished in this application are complete and genuine.</p><p>Signature:</p><p>Name:</p><p>Position </p><p>Company Stamp: BAJRAWIA FACTORY Page 8 of 8 FOR OIL AND GAS EQUIPMENTS Doc. No. BAJ-PUR-VA-011 Rev PROCUREMENT QUALITY PROCEDURE 00 VENDOR REGISTRATION PROCEDURE Date DD/MM/YYYY</p><p>Document Checklist</p><p>STATUS # Applicable Document (Submitted ( √ ) not submitted (X)) 1 Business License and/or Certificate of Incorporation Memorandum and article of association approved from 2 government authorities Please attach the last endorsement (form (9A)) last 3 updated ones 4 Organization Chart and resumes</p><p>5 Last three years financial statements</p><p>6 Value added tax and Zakat authority release certificate</p><p>7 HSE & Quality manuals and certificates (if any)</p><p>8 Accreditation Certificates</p>