VENDOR/SUPPLIER REGISTRATION FORM

Document No.
Issue Date
Issuing Department  *  

 For Pak Qatar Takaful Group

Receive Date                       
Name/Designation of Receiver  *                         
General Instructions

Vendors interested in becoming registered with PQTG must pre-register with the Procurement Department/Vendor relation section. This registration process is mandatory and supersedes all previous registration, such registration is valid for “3“ years, thereafter, it is the vendor’s responsibility to renew their registration in a timely manner at least 3 months ahead of expiry. All new and existing vendors are required to register by completing this form and submitting the following documents along with it.

  1. Copies of Firm registration and incorporation, Sales Tax, NTN certificates, Memorandum of Article
  2. Copies of Final Income Tax Returns for the last two years.
  3. Name and Designation wise Sales, After Sales and back-office personnel details with contacts (Email, Cell Number or Land-Line numbers)
  4. Copies of valid foreign Agency Agreement/dealership/ distributorship, if applicable.
  5. Company profile along with past experience over the last two years stating major supplies/contracts/services, with values and corresponding client names.
  6. Products and service categories check list marking the categories you are able to provide.
  7. All pages of this registration form & related documents must be signed and stamped by the authorized signatory.

All parts of the registration form must be completed, and all above requirement must be fully complied with. Registration with PQTG, if accepted, does not constitute any obligation by Pak-Qatar Takaful Group to guarantee any tender invitation, contractual awards or any order for product or service. Incomplete application and/or missing information shall not be dealt with; all queries regarding registration should be directed to PQTG via Email or on mentioned PABX numbers. All parts of this registration form must be completed, incomplete forms will not be processed (Apply only if your firm has been established firm)

Part 1 Purpose - Please tick as appropriate.






 

Part 2 - Type of Organization.

Part 3 - Certificates Validity.

S.No Certificate   Certificate No Expiry Date
1 Incorporation Certificate  *                         
2 Firm of Registration Certificate  *      
3 Sales Tax Number  *      
4 National Tax Number (NTN)  *      
5 ISO Certification/ Quality Assurance / Quality Policy (If any)  
6  

Part 4-Official Name/ Address/ Contact details (Legally binding) (At least 3 contact person with their Tel Number/Mobiles number are mandatory).

 

Name of Firm *
 
(LEGAL NAME AS PER INCORPORATION CERTIFICATE)
Major Item of Supply  *
 
(State only one)
 
ADDRESS DETAILS
(Kindly attach seprate list of your branches on the same format)
At lest three (3) contact persons along-with contact details are required
DESCRIPTION HEAD OFFICE URGENT/EMERGENCY(24/7)
1 2 3
CONTACT PERSON NAME
DESIGNATION
PO BOX
POSTAL CODE
CITY / TOWN
COUNTRY
TELEPHONE NO
MOBILE NO
FAX NO
OFFICE ADDRESS-1
OFFICE ADDRESS-2
OFFICE ADDRESS-3
E-MAIL ADDRESS -1
E-MAIL ADDRESS -2
E-MAIL ADDRESS -3
Note: Only Office Address is required.

Part 5 - Staff strength:

a.Total Number of Employees: *              
b.Technical Support Staff:(Insert more rows as desired please)
S.NoDESIGNATION / POSITIONNO. OF STAFF
1
  

Part 6 - ownership:

PLEASE SPECIFY OWNER/PARTNERS/SHAREHOLDERS NAME/NAMES WITH SHARE PERCENTAGE.
S.NoNAME & PARENTAGENATIONALITYNO. OF SHARES
1
   

Part 7 - Authorized Signatories (Key Personnel) Authorized to Signs Bids/Offers & Contracts:

S.NoNAME & PARENTAGE *POSITION *
1    
  

Part 8 - Firm Remit Details (For payment Purposes).

SAME AS PART 4, tick only IF NOT, COMPLETE THE FOLLOWING.
Name, Remit To

Address, Remit To
City
Sector
Telephone #
FAX #
Contact Person  
 
1. Is your company/establishment/entity aware about and subsequently compliant as per the Anti-Money laundering/CFT laws prevalent in Islamic republic of Pakistan? If No, then why?

2. Is your company exposed to any risk determined as per the AML/CFT Laws? If yes, then please share the details.

3. Does your company have any AML/CFT related Policy in the field?

4. Is any of your Director or Member of the Senior Management a Politically Exposed Person (PEP)? If yes, then please share the details of the respective individual(s). For this question PEP means individuals who are or have been entrusted domestically with prominent public functions, for example Heads of State or of government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations, important political party officials.

5. Is any of your Director or Member of the Senior Management a Foreign National? If yes, then please also inform us that if any of your foreigner Director or Senior Management is Foreign Politically Exposed Person? If yes, then please share the details of the respective individual(s). foreign PEPs, individuals who are or have been entrusted with prominent public functions by a foreign country, for example Heads of State or of government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations, important political party official AND Persons who are or have been entrusted with a prominent function by an international organization, means members of senior management and members of the board or equivalent functions

6. Has your company/institution/entity been the subject of any money laundering or terrorist financing-related proceedings, investigations, sanctions, punitive actions indictment, had fines, conviction or civil enforcement action imposed on your company/institution/entity or Directors or member of your senior management by a regulator or law enforcement body during the last five years?

 

7. Does your company/institution/entity receives any kind of funding/donations/charities received from any sources which are under investigation locally or from any sources which are based in foreign? If yes, then please share the details.

8. Has your company/institution/entity, to your knowledge, been the subject to any investigation, indictment, penalty, fine, conviction or civil enforcement action related to terrorism financing in the past five years?

 

9. Is your company/institution/entity engaged in any sort of business activities with the countries being marked as AML non-compliant by the FATF or UN? If so, then please share the details.

I/We hereby declare that all the information provided above are correct and true, and if any changes are made in aforementioned queries during the term of the contract, then the same may be intimated to PQTG forthwith.