Vendor Registration Form

Bangkok, Thailand

Section 1: Company Details and General Information

1. Name of Company:

2. Address and Contact

Street1
Street2
Street3
City/Province
Post code
State
Country
Telephone	(Country Code) Tel. No., e.g. (66) 123-4567
Fax	(Country Code) Tel. No., e.g. (66) 123-4567
Email
Web Site

3. P.O. Box and Mailing Address: (if different from above)

4. Parent Company (Full legal Name) :

5. Provide a listing of Subsidiaries, Associates and/or Overseas Representative(s), if any:

6. Type of Business (check one only) :

Corporate/ Limited
Partnership
Private Firm
Family Business

7. Nature of Business: If you check “Authorized Agent or “General Trader”, please provide proof or certificate(s) from your manufacturer(s) that you are authorized to offer their products to the United Nations. (Please send hard copy to our mailing address)

Manufacturer
Authorized Agent [Goto question 8]
General Trader [Goto question 8]
Consulting Firm

8. List of authorized Product/Brands

Product/Brand 1
Product/Brand 2
Product/Brand 3
Product/Brand 4
Product/Brand 5
Product/Brand 6

9. Year Established (Minimum of 3 years establishment required):

10. Number of full time employees

11.

License No. and Country where registered
Tax/VAT ID Number

12. Have you previously registered or attempted to register with United Nations ESCAP in Bangkok?

Yes No

13. Have you registered with United Nations Global Marketplace (UNGM) ?

Yes, please indicate vendor number:
No

14. Have you registered with United Nations Headquarters Procurement Service in New York?

Yes, please indicate vendor number:
No

15. Technical Documents available in: (check all that apply)
16. Working Languages: (check all that apply)

Section 2: Financial Information

17. Annual Value of Total Sales for the last 3 Years:

Year		: USD
Year		: USD
Year		: USD

18. Annual Value of Export Sales for the last 3 Years:

Year		: USD
Year		: USD
Year		: USD

19. Please attach
i) a listing of a minimum of three (3) reference sources for services rendered by your firm within the last 12 months and
ii) original of recommendation letter from the reference sources describing the nature of services rendered by your firm. The recommendation letter must be prepared in the reference sources’ letterhead and signed by their representatives, who awarded an order to your firm or who administered your contract.

Please also indicate fax numbers and contact person for your reference sources so that the United Nations can contact them as and when required. If you list any references under Section 4, item 28 below, you must also include the details here.

	Company 1
Name of Company
Address
Phone
Fax Number
	Company 2
Name of Company
Address
Phone
Fax Number
	Company 3
Name of Company
Address
Phone
Fax Number

Note: For security reasons and to complete the vendor registration, please send the following to our mailing address:.

Certified copy of recent balance sheet
Publicly traded companies are required to provide audited financial statement or annual report to shareholders;
Bank name, SWIFT/BIC address, Bank address, Bank account number, Account name.

Section 3: Technical Capability and Information on Goods / Services Offered

20. Quality Assurance Certification (e.g. ISO 9000 or equivalent)

Yes (please send hard copy of your latest certification to our mailing address)
No

21. International Offices/Representation (Countries where the Company has local Offices/Representation):

22. List below, up to seven (7), of your core Goods/Services offered. You must enter United Nations Global Market Place product Codes ONLY. See details on this web site : UNCCS codes. Please cut and paste both codes and descriptions into this form.

Item	UNCCS product code	Description
1
2
3
4
5
6
7

23. For your core goods / services specified in item 22 above, please provide details of the largest sales in the last financial year including name of company, name of contact person, address and fax number of customer and value of sales.

1)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
2)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
3)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
4)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
5)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
6)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:
7)	UNCCS product code and Description
Company:		Contact Person:
Address:		Fax Number:

Section 4: Experience

24. Please list recent contracts with the United Nations and/or national Government

	Year	US$	Organization	Goods/services supplied	Destination
1
2
3
4
5
6

25. To which Countries has your Company exported and/or managed projects over the last 3 Years?

Section 5: Other

26. Please list any current legal disputes in which your company may be involved.

27. List any national or International Trade or Professional Organisations of which your Company is a Member.

28. Acceptance of payment terms and other discounts (Mark all that apply)

Net 30 days:
Prompt payment discounts:
Other discounts:

29. Tender Documents:
Do you prefer to receive tender documents (Mark your preference)

By facsimile
By electronic mail:
By registered mail:

30. The United Nations may require a contractor to provide the United Nations with a Performance Bond (to guarantee fulfilment of terms and conditions) when contracts are awarded. Please indicate the maximum amount of Performance Bond your company is able to support:

US$

Section 6 Additional

31. List the firm’s members, include qualifications of the principal partners and their heading of particular areas of practice.

32. Location of Offices, Jurisdiction, and Areas of Significant Practice Experience.

1.	Location
	Jurisdiction
	Area of experience

2.	Location
	Jurisdiction
	Area of experience

3.	Location
	Jurisdiction
	Area of experience

4.	Location
	Jurisdiction
	Area of experience

33. List of affiliations with other law firms.

	Name	Location	Nature of affiliation
1
2
3

34. Professional Indemnity Coverage

Item	Geographical area	Amount
1
2
3

35. Certification: I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes, details will be provided as soon as possible

Name (type in full name in lieu of signature)
Functional Title
Date