MANUEL S. ENVERGA UNIVERSITY FOUNDATION
An Autonomous University
LUCENA CITY
PROCUREMENT OFFICE
QUALITY FORM
Document Code: PO-F-AASS
Document Title: Application for Accreditation
of Suppliers/Subcontractors
Page No: 1 of 1
Revision No.: 1
Effectivity Date: February 2013
Prepared by: PO
Reviewed by: QMR
Approved by: President
APPLICATION FOR ACCREDITATION OF SUPPLIERS/SUBCONTRACTORS
Instructions: Please fill in all information. Write NA if not applicable. Incomplete data will invalidate your application.
A. BACKGROUND INFORMATION
Business Name
Business Address
Warehouse Address
Telephone Number
Fax Number
E-mail Address
Main Owner/Proprietor
Authorized Company Representative
B. BUSINESS ORGANIZATION (Please tick off ( / ) your answer.)
☐ Corporation
☐ Partnership
☐ Single Proprietorship
☐ Others, please specify ____________
C. BUSINESS REGISTRY (Please submit a photocopy of the applicable permits indicated below.)
Current Municipal/City Permit
Department of Trade and Industry (DTI) Permit
SEC Registration and Articles of Incorporation and By-Laws
BIR Certificate of Registration (BIR Form 2303)
D. PRODUCT LINE
Enumerate major product lines or services.
E. ASSETS AND LIABILITIES
From most recent fiscal or calendar years; please attach a photocopy of the latest Balance Sheet and Income Statement.
Total Equity
Total Current Assets
Total Current Liabilities
Gross Income (Deficit)
F. ADDITIONAL SUPPLIER/SUBCONTRACTOR INFORMATION
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9.
How many years have you been a business supplier/subcontractor? _____________________________________________________________________
What is your warranty capability? ________________________________________________________________________________________________
Do you have after sales service? ______________ If none, are you willing to offer after sales service? __________________________________________
Will you be willing to accommodate urgent requests? _________ If yes, what is the shortest period of time? ____________________________________
Are you willing to be evaluated? _____________ Will you accommodate store/plant visit? ___________________________________________________
What is your payment preference? Please specify. ____________________________________________________________________________________
Can you replace returned products promptly? _______________________________________________________________________________________
How quickly can you deliver after receiving a purchase order? Please specify number of days. _________________________________________________
List at least three (3) major clients/projects. For each, please state contact person and contact number/s.
Client/Project
Contact Person
Contact Number
I certify that the above information is true, complete and correct. I understand that any misrepresentation or material omission made or in any
document requested by the Manuel S. Enverga University Foundation renders accreditation, if approved, null and void.
By: ________________________________________________
Please print name and affix signature
____________________________________
Date