SUPPLIER PROFILE/REGISTRATION FORM Email Please fill in this questionnaire in order to register. Information given in this questionnaire will be handled confidentially. Please attach all other documents requested in the questionnaire. NAME OF COMPANY * MAILING ADDRESS COUNTRY CONTACT PERSON(S) TELEPHONE FAX INTERNET (E-mail) WEBSITE TYPE OF ORGANISATION (Please check) TYPE OF ORGANISATION (Please check) Individual Partnership Non-Profit Organisation Private Limited Liability Company Public Limited Liability Company Other Please explain (If TYPE OF ORGANISATION is Other) Year Established Under the laws of Quoted on the Please attach copy of registration certificate TYPE OF BUSINESS (Please check) TYPE OF BUSINESS Manufacturing Trading Other Please explain (If TYPE OF BUSINESS is Other) Please describe your company's major business activity PERSONS AUTHORISED TO SIGN BIDS, OFFERS AND CONTRACTS Name Position Telephone / Fax Name Position Telephone / Fax Name Position Telephone / Fax BANKING INFORMATION Name Address Account Number SWIFT Code IBAN Please specify your quality assurance standards NAMES OF OFFICERS, OWNERS OR PARTNERS Owner(s) Chief Executive Officer Chief Financial Officer ENVIRONMENTAL CONSIDERATIONS Have you identified the main environmental impacts / risks of your activity? Yes No (If yes, please provide details) Have you set up any policy/ objectives in order to limit your environmental impacts? Yes No (If yes, please provide details) Are there any resources dedicated to environmental management, (i.e. systems, team)? Yes No (If yes, please provide details) PAYMENT TERMS: The PADMANABHAM shall make payments within 30 days fol-lowing receipt of goods in good order and all requested documentation. Payments, shall be made only against supplier's invoice and shall be subject to conformity of goods to specifica-tions. For your information, the PADMANABHAM's documentation requirements frequently include an acknowledgement of delivery certificate signed by a local representative of the PADMANABHAM. Please note that any non-acceptance of these terms may preclude your company from being considered as a potential supplier. QUALITY ASSURANCE (Please attach any certificates or documents which denote quality assurance) GENERAL TERMS AND CONDITIONS: Please carefully read the attached General Terms and Conditions of the PADMANABHAM of Red Cross and Red Crescent Societies and confirm your acceptance of these terms and conditions as final by way of signing and return-ing. PRINCIPLES OF CONDUCT: Supplier seeking to work with the PADMANABHAM shall respect the following principles: Business Ethics: supplier is expected to maintain the highest degree of business ethics when working with the PADMANABHAM. Transparency of information provision: supplier shall not be involved in any fraudulent ac-tivities, misrepresent information or facts for the purpose of influencing the selection and con-tract awarding process in its favour. Fair competition: supplier shall not be involved in any corrupt, collusive or coercive prac-tices. If at any time during the registration or procurement process the PADMANABHAM deter-mines that the supplier is in violation of the above mentioned principles, that supplier’s request for registration or bid may be rejected as ineligible. The respect of fundamental human rights and labour standards is stipulated in the General Terms and Conditions, and must be accepted by you as a condition of contracting with the PADMANABHAM. Any refusal of these terms shall constitute grounds for rejection of sup-plier’s registration request or bid; and any violation during a contract terms shall constitute grounds for termination. REGISTRATION REJECTION: Registration application may be rejected for the following reasons: - Bankruptcy or a decision of legal incompetence - Criminal conviction or civil judgement against you or your managing director (or equivalent) for the commission of any offence indicating a lack of business integrity or business honesty - Grounds for suspicion of breach of established PADMANABHAM standards (violation of the fundamental principles or social and ethical standards) - Any refusal of any of the principles of conduct and any refusal to the respect of fundamental human rights and labour standards - Refusal of the PADMANABHAM standard payment terms CERTIFICATION: The undersigned, an authorised signer for the company, hereby certifies that the information provided herein, including that on any attached pages is true and correct to the best of his/her knowledge. The same acknowledges having read and agreed to the PADMANABHAM's payment terms of 30 days credit.