VENDOR
REGISTRATION
APPLICATION
1
Supplier Database
Tshwane University of Technology
The Tshwane University of Technology is developing a vendor database which will
assist with requests for quotations and tenders.
These forms must be completed and returned to the following address:
Tender Box
Pretoria Campus
Building 6, Ground Level,
Staatsartillerie Road,
Pretoria West
Please complete the forms in all detail – use black pen.
Please print so that all information is legible.
Forms that are not readable or incomplete will be rejected.
New Application
Yes
No
If No, please supply current creditor number.
PLEASE KEEP COPIES OF THE REGISTRATION FORM AND ALL
DOCUMENTATION SUBMITTED FOR YOUR OWN RECORDS AS
NO COPIES WILL BE MADE BY THE UNIVERSITY
2
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POINTS TO REMEMBER
-
COMPLETING VENDOR REGISTRATION APPLICATION FORM
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Mandatory fields – Certain fields and documents are mandatory to certain business types only.
Please ensure that all fields mandatory to your business type which are marked as “Mandatory
Field” have been completed and if a field is not applicable to your business type, clearly mark it as
N/A.
Required documentation – Please refer to the attached table (Following page) to determine the
mandatory supporting documentation required for your business type. Please ensure that all copies
of Mandatory documents (certified copies where applicable) are attached.
Completion of questions – Clearly state Yes, No or N/A to questions asked. Do not leave any
Mandatory fields blank.
Certified Documents – Please ensure that a Commissioner of Oaths has certified your Company
Registration document and Proof of Shareholding Certificates. The stamp of certification should be
on the front of the document.
Copies of Documents - Please keep copies of the registration form and all supporting
documentation submitted for your own records and to ensure that all data is maintained and up to
date on a continual basis.
Owners, Shareholders and Partners – Please ensure that the percentage of ownership
calculated up to 100% and that a field is completed for each of the business owners.
Certification of Correctness – Please ensure that the Certification of Correctness is signed and
dated once all required documents and information have been submitted.
Collection points – Completed registration forms and supporting documentation can be delivered
to the address on the registration form.
Processing of registration – Your completed registration will be processed and once verified, will
be approved and you will be issued with a Vendor Registration Number to be used in all future
communication with Tshwane University of Technology. The letter of verification will be dispatched
to the correspondence details supplied on page three. Please note that this administration process
will take a minimum of 5 days. Once your registration has been included on the TUT Database your
details will be accessible to the purchasing officers of TUT.
Business Opportunities – Please note that registration on the TUT Supplier Database does not
guarantee business opportunities. Inclusion of the name in a database does not in any way
guarantee any persons, company, service provider, vendor, etc. any business from the Tshwane
University of Technology. All procurement will be subjected to the Procurement- and Tender
policies of Tshwane University of Technology.
Amendments – Please notify the Tshwane University of Technology – Procurement Department
immediately of any changes to the verified information submitted.
Queries – Should you have any queries or if you require assistance completing the registration
form, please contact the Procurement office on (T) 012-3825207.
If a company has more than one office, each office must fill in a separate from unless the point of
transaction is centralized in the company’s head office.
Please note that the key facilities in the database are classified as commodities and each potential
vendor must indicate the commodity/commodities in which it would like to register for RFQ’s.
The main objective of this process is to enhance transparency and equality on the part of the
University and to facilitate effective communication with its vendors.
Applications must be delivered by hand and must be fully completed with all the relevant
documentation attached.
It is a condition of bidding that a vendor’s taxes must be in order or satisfactory arrangements must
have been made with the Receiver of Revenue to meet his/her tax obligations. In bids where
consortia/joint ventures/sub contractors are involved, each party must submit a separate valid Tax
Clearance Certificate.
3
PLEASE KEEP COPIES OF REGISTRATION FORM AND ALL DOCUMENTATION SUBMITTED
FOR OFFICIAL USE ONLY
Name of Business
Registration Number
Documents
required
Sole
Proprietor
Company
Registration
Certified
Copies
Proof of
Ownership
Certified
Copies
Regional
Services
Council
Close
Corporation
and Private
Companies
Where to
get documents
Business
Type
Partnerships
Public
Company
Business
Trust
Non Profit
Organizations
Trust
agreement
Certificate of
incorporation
Section 21
N/A
Certificate of
incorporation
CK1/CK2
Partnership
agreement
Certificate of
incorporation
CM3
N/A
Certificate of
incorporation
CK1/CK2
Partnership
agreement
Certificate of
incorporation
CM3
Yes
Yes
Yes
Yes
Yes
Yes
Bank
Statement/
cancelled
cheque
For the
owner or
the
business
For the
owner or
the
business
If staff are
employed
Bank
Statement/
cancelled
cheque
For the
company/cc
Bank
Statement/
cancelled
cheque
For the
partnership
Bank
Statement/
cancelled
cheque
For the
company
Bank
Statement/
cancelled
cheque
Bank
Statement/
cancelled
cheque
For the
company/cc
For the
partnership
For the
company
If staff are
employed
If staff are
employed
If staff are
employed
If staff are
employed
If staff are
employed
VAT
Registration
If registered
for VAT
If registered
for VAT
If registered
for VAT
If registered
for VAT
If registered
for VAT
If registered
for VAT
U.I.F
Certificate
Workman’s
Compensation
Security
Officer’s
Board
If staff are
employed
If staff are
employed
If applicable
– for
security
industry
If staff are
employed
If staff are
employed
If applicable
– for security
industry
If staff are
employed
If staff are
employed
If applicable
– for security
industry
If staff are
employed
If staff are
employed
If applicable
– for security
industry
If staff are
employed
If staff are
employed
If applicable
– for security
industry
Proof of
Disability
Proof of
Identity
If owner is
disabled
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Clear copy of
Owner’s ID
doc.
If owner is
disabled
Clear copy
of Owner’s
ID doc.
If staff are
employed
If staff are
employed
If
applicable
– for
security
industry
If owner is
disabled
Clear copy
of Owner’s
ID doc.
Proof of
Banking
Income Tax
Tax
Clearance
certificate
P.A.Y.E
4
Trust
details:
Letter of
Authority
Auditor’s
letter – no
shareholding
Registrar of
Close
Corporations &
Companies
Registrar of
Close
Corporations &
Companies
City of
Tshwane/Local
Authority if not
based in
Tshwane
Branch of Bank
where account
is held
For the
Trust
For the Trust
Receiver of
Revenue
(SARS)
For the
Trust
For the Trust
Receiver of
Revenue
(SARS)
If owner is
disabled
Clear copy of
Owner’s ID
doc.
Receiver of
Revenue
(SARS)
Receiver of
Revenue
(SARS)
Department of
Labour
Department of
Labour
Security Service
Industry
Regulatory
Authority
Medical
Practitioner
Department of
Home Affairs
Department of Labour (U.I.F certificates)
94 Church street, Pretoria
012 337 1802
CONTACT DETAILS
Department of Labour (Workman’s Compensation
Compensation House, Cnr Hamilton & Soutpansberg Rd,
Pretoria
012 319 9111
Security Service Industry Regulatory Authority
481 Belvedere Street, Arcadia
012 337 5500
Registrar of Close Corporations & companies
Zanza Building, 116 Proes Street, Pretoria
086 184 3384
City of Tshwane/Local Authority if not based in
Tshwane
HB Phillip Building, 320 Bosman Street, Pretoria.
012 337 4000
Receiver of Revenue (SARS)
c/o Schoeman & v.d. Walt Street, P.O. Box 436, Pretoria
0001
012 317 2000
COMMODITY GROUPS
PLEASE NOTE:
Any vendor may only register for a maximum of four commodity groups
Tick
Cat
No
001
002
003
Description
Laboratory equipment
Fasteners, Bolts, Nuts,
Rivets & Washers
Containers &
Packaging
Tick
Cat
No
030
031
Description
032
Welding & Flame Cutting
Equipment
Office Furniture,
Components &
Accessories
Hospital, Medical &
Surgical Equipment &
Furniture
Outdoor & Pavement
Furniture
Agricultural &
Horticultural Equipment
& Machinery
Compressors, Blowers &
Vacuum Equipment
Air conditioners,
Ventilation, Fans &
Coolers
Furnaces, Kilns, Ovens
& industrial Dryers
Office Machines &
Equipment
061
Machine Tools &
Accessories
Radio, Television,
Audiovisual &
Communication
Equipment
Pumps, Engines, Spares
& Accessories
Fertilizers
070
033
004
Bricks & Blocks
005
Canteen, Kitchen &
Cooking equipment &
Appliances
Tableware,
Hollowware & Utensils
Sand, Soil, Cement &
Concrete
034
Home & Industrial
Fabrics & Textiles
Clothing, Safety
Clothing & Footwear
037
Cordage, Ropes,
Twines, String & Nets
Electronic
Components &
Equipment
Computer Hardware &
Supplies
039
006
007
008
009
010
011
012
035
036
038
040
041
042
013
Computer Software &
Solutions
014
Electric & Data Cable,
Wire &Equipment
Electric Lamps,
Lighting & Accessories
015
043
044
Printing Supplies
General Foodstuffs
5
Tick
Cat
No
059
060
062
063
064
065
066
067
068
069
071
072
073
Description
Brush ware
Power Tools &
Accessories
Hand Tools &
Accessories
Transport Hire &
Transport and
Cartage Services
Catering & Events
Equipment Hire
Engineers &
Contractors
Castors, Ladders,
Trolleys & Wheels
Recreational & Sports
Requisites
Artwork, Crafts,
Curios & Gifts
Hygiene, Beauty &
Cosmetic Products
Publications, Videos &
Films
Fresh Flowers, Plants
& Seeds
Medications &
Pharmaceuticals by
General Classification
Financial, Insurance &
Legal Services
Analysis, Inspection &
Evaluation Services
016
General Electrical
Equipment & Parts
Control, Process &
Measurement
Instrumentation
045
Animal Feeds
074
Installation Services
046
075
Maintenance & Repair
Services
018
Test & Analysis
instrumentation
047
076
Manufacturing &
processing Services
019
Scopes, Lenses &
Optical Equipment
Security Equipment &
Requisites, Walling,
Fencing & Gates
Signs, Nameplates,
Notices & Labels
Engravers, DieSinkers & Embossers
Insulation Products
Precious Stones and
Materials
048
Transport Vehicles,
Trailers, Motorcycles,
Boats, Aircraft & Spares
& Accessories
Washing, Scrubbing,
Cleaning Plant and
Supplies
Nails, Pins, Screws &
Staples
Fuels, Petrol, Oils &
Lubricants
077
Cleaning Services
078
Administration &
Management Services
Coatings, Waterproofing
& Paints
Stationery
079
052
053
Steel, Pipes and Profiles
Valves and Pressure
Vessels
081
082
Building requisites,
fittings & Materials
Flooring Products
054
Pest Control and
Cleaning materials
Adhesives
083
Engineering & Related
Services
Advertising &
Marketing Services
Consultants
Communication,
Publishing & Printing
Services
Consulting Engineers
Sanitary ware &
Accessories
Sewing, Knitting &
Textile Machines &
Equipment
Printing, Marking,
Engraving & Labeling
Equipment
Accommodation,
Tourism &
Entertainment
Agricultural Services
Retailers &
Wholesalers
056
Heaters and Heating
Equipment
Timbers and Timber
materials
085
Chemicals &
Associated Products
Security Services
086
Food Services
058
Plant & Equipment Hire
087
Computer Related
Services
091
Government Services –
National, Local &
Municipal
017
020
021
022
023
024
025
026
027
028
029
088
089
090
049
050
051
055
057
080
084
092
Documents Attached
Yes
Workman’s Compensation Certificate (Certified)
Regional Council/District Registration (Certified)
VAT 103 (Certified)
P.A.Y.E./SDL/UIF (EMP103) (Certified)
Company Registration Document (Certified)
Proof of Ownership/Shareholder certificate (Certificate)
Tax Clearance Certificate (Original)
Proof of Banking Document
Disability Documents (Certified)
Security Officer’s Board registration (Certified)
Municipal Account
Labour Broker
6
Please tick
box
No
N/A
Please note: Proof of documents for all of those above are required to ensure successful registration on the Supplier
Database. In event of a document not being required please tick the N/A box.
1. COMPANY REGISTRATION DOCUMENTS
NB. DOCUMENTARY PROOF MUST BE PROVIDED WHERE APPLICALE (Please mark N/A if not applicable.)
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
1.1
COMPANY TYPE * (NB. Documentary Proof of Registration must be provided)
PUBLIC COMPANY LTD
CERTIFIED COPY OF CERTIFICATE OF INCORPORATION
(CM 3) and
REGIONAL COUNCIL REGISTRATION NUMBER
PRIVATE COMPANY (PTY) LTD
CERTIFIED COPY OF CERTIFICATE OF INCORPORATION
(CM 3) and
REGIONAL COUNCIL REGISTRATION NUMBER
CLOSE CORPORATION CC
CERTIFIED COPY OF CK1 DOCUMENT OR CK2 IF
APPLICABLE and
REGIONAL COUNCIL REGISTRATION NUMBER
SOLE PROPRIETOR
COPY OF REGIONAL COUNCIL REGISTRATION
DOCUMENT
PARTNERSHIP
COPY OF REGIONAL COUNCIL REGISTRATION
DOCUMENT and
PARTNERSHIP AGREEMENT
BUSINESS TRUST
COPY OF REGIONAL COUNCIL REGISTRATION
DOCUMENT and
CERTIFIED COPY OF REGISTRATION DOCUMENT
OTHER (If Joint Venture)
COPY OF REGIONAL COUNCIL REGISTRATION
DOCUMENT and
CERTIFIED COPY OF REGISTRATION DOCUMENT
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
Company, CK or Regional Council Number
Not applicable to all companies, please specify if N/A.
Did you attach your company Registration document?
Y
N
N/A
1.2 PROOF OF SHAREHOLDING DOCUMENTS *
CERTIFIED COPIES of Shareholders certificates or CK members share allocation documents
must be supplied.
Not applicable to all companies, please specify if N/A.
7
Did you attach your proof of shareholders documents?
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
1.3 REGIONAL COUNCIL REGISTRATION DOCUMENTS *
Regional Council Reference Number
Did you attach your proof of shareholders documents?
1.4 PROOF OF BANKING DOCUMENTS *
Current bank statement or copy of cancelled cheque.
Did you attach your proof of banking document?
1.5 VAT REGISTRATION NUMBER #
VAT Registration Number
If you qualify for VAT exemption, please attach a VAT exemption document
Not applicable to all companies, please specify if N/A
Did you attach proof of your VAT registration (VAT 103)?
1.6 P.A.Y.E. DOCUMENT #
Not applicable to all companies, please specify if N/A
Did you attach proof of your P.A.Y.E. document?
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
1.7 UNEMPLOYMENT INSURANCE FUND DOCUMENTS #
U.I.F Number
Not applicable to all companies, please specify if N/A
Did you attach proof of your UIF document?
Y
N
N/A
Y
N
N/A
1.8 WORKMAN’S COMPENSATION FUND DOCUMENTS #
Workman’s Compensation Fund No.
Not applicable to all companies, please specify if N/A
Did you attach proof of your Workman’s Compensation Fund Number?
8
1.9 SECURITY OFFICERS BOARD REGISTRATION #
Security officers board registration no.
Not applicable to all companies, please specify if N/A
Did you attach proof of your Security Officers Board Registration?
1.10
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
DISABILITY DOCUMENTS #
Not applicable to all companies, please specify if N/A
Did you attach proof of your disability?
1.11
INCOME TAX REGISTRATION #
Income Tax Registration No.
Not applicable to all companies, please specify if N/A
Did you attach proof of your Income Tax Registration?
1.12
TAX CLEARANCE CERTIFICATE *
Original of valid Tax Clearance Certificate must be supplied
Did you attach a valid Tax Clearance Certificate?
1.13
CIDB REGISTRATION #
CRS Registration No.
Current CIDB Grading
Not applicable to all companies, please specify if N/A
Did you attach proof of your CIDB Registration?
1.14
NHBRC REGISTRATION #
NHBRC Registration No.
Not applicable to all companies, please specify if N/A
Did you attach proof of Registration?
9
1.15
TRANSPORT OPERATORS #
PDP Permit No.
Not applicable to all companies, please specify if N/A
Y
Did you attach a copy of your PDP Permit?
N
N/A
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
2. BUSINESS PARTICULARS *
2.1 Name of Business*
2.2 Physical address *
City
Code
Province
2.3 Postal address *
City
Code
Province
2.4 Telephone Number. *
2.5 Fax Number. *
2.6 Cell Number. *
2.7 E-Mail Address. *
2.8 Web-Page Address. *
10
2.9 How would you like to receive your correspondence from us? *
Post
Fax
E-Mail
2.10 Correspondence Address *
City
Code
Province
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
Contact Person for correspondence as per 2.10
Title
Name
Surname
3. SALES AND ACCOUNTS DEPARTMENT *
3.1 Sales Department *
Contact Name
Cell No
E-Mail Address
Telephone
Fax
3.1 Accounts Department *
Contact Name
Cell No
E-Mail Address
Telephone
Fax
4. CORE BUSINESS OPERATION *
(Mark with X in applicable fields)
Prime Contractor
Sub-Contractor (Less than 25% generated turnover as prime contractor
Labour-only Contractor
Supplier
Manufacturer
Labour Agency
Professional Services
Education, Development &
Training Service Provider
Construction (CIDB)
11
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
Other, please specify ………………………………………………………………………………………
…………………………………………………………………………………………………………………
5. ANNUAL AVERAGE TURNOVER *
Indicate annual average turnover excluding Value Added Tax during the past three years:
.
R
6. FINANCIAL DETAIL (BANKING) *
Banking institution name
Branch
Town/City
Banking account number
Account type
Account holder’s name
NB. DOCUMENTARY PROOF OF BANKING INSTITUTION MUST BE SUPPLIED (Cancelled
Cheque/ Bank Statement)
7. PREVIOUS BUSINESS INFORMATION *
7.1
Did your business exist under a previous name?
7.2
If Yes, what name did it trade under?
7.3
Previous business registration number?
12
Yes
No
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
8. BUSINESS INFORMATION *
The following table must be completed in order to establish whether a business can be classified
as an SMME in terms of the National Small Business Act 102 of 1996. Indicate the sector by
ticking the appropriate block in column 1.
Economic Sector
Type of Business
Agriculture
Mining and Quarrying
ISO Listed
Manufacturer
Manufacturing
Electricity, Gas and Water
Construction
Retail, Motor Trade and Repair Services
Wholesale Trade, Commercial gents & Allied Services
Catering, Accommodation & other Trade
Transport, Storage and Communications
Finance and Business Services
Community, Social & Personal Services
Distributor
Sales
Services
Importer
Exporter
Repairer
9. LABOUR BROKERS
Please answer the questions by marking the appropriate column with an “X”. Please do not leave
out any questions relating to your special circumstances.
1. Do you render service to TUT through a Company, Close Corporation or Trust?
Yes
No
2. Are you an Independent Contractor?
Yes
No
3. Are you a Labour Broker?
(If yes = taxable unless IRP30 certificate is received. If no, see next questions)
Yes
No
4. Are the services personally rendered by a person who is a connected person
(shareholder, member, trustee, beneficiary, relative of the afore-mentioned, etc.)
in relation to the Company/Close Corporation or Trust?
(If yes, see question 5, 6, 7, 8 and 9. If no = not subjected to employees tax)
Yes
No
5. Does the entity employ four or more employees. (other than shareholders, members
or connected persons) who are on a full-time basis engaged in the business of
rendering services to clients?
(This implies that the tea lady and gardener would not be considered in determining
the full-time staff members rendering services to clients).
Yes
No
6. Would the person who is rendering the services be regarded as an “employee” of TUT? Yes
No
7. Is the person who is rendering the service subject to control or supervision of TUT
as to the manner in which duties are performed or as hours of work?
No
13
Yes
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
8. Do the amounts paid in respect of services rendered include earnings that are
payable at regular, daily, weekly, monthly or other intervals? (This is normally on
the basis that you charge your client for the person in question’s salary plus
commission for your service?
Yes
No
9. Does the Company/Close Corporation or Trust, during its financial year, receive or
anticipate to receive more than 80% of income for this specified service from TUT?
(If yes to any of questions 6, 7, 8, or 9, then taxable, except if IRP30 certificate
can be submitted.
If no to all four questions (6, 7, 8 and () = Not subject to employees tax.
Yes
No
Subject to employees tax?
Yes
No
10. HDI INFORMATION *
Explanation of abbreviations used in the tables to follow:
Capacity
Director
Partner
Member
Proprietor
Other
D
P
M
R
O
HDI Status
HDI
Women
Disabled
H
W
D
Please note that proof of disability must be provided by a recognized institution and certified copies of such
certification needs to be attached to this application.
NB. CERTIFIED COPY OF SHAREHOLDER CERTIFICATES OR PROOF OF OWNERSHIP MUST BE
SUPPLIED
(Multiple copies of this page may be submitted if required)
10.1 Complete the following for the shareholders who are actively involved in the management and
daily business operation of the business
First Name
Surname
Identification Number
%
Percentage of Share
Capacity
Gender
HDI Status
Disabled (a permanent impairment of a physical, intellectual or sensory function resulting
In restricted or lack of ability to perform in a manner considered normal for a human being) Yes
No
Were you a South African citizen on or before 26th April 1994?
Are you actively involved in the management and the daily business operations
of the business
(Please provide a written breakdown e.g. company profile)
14
Yes
No
Yes
No
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
First Name
Surname
Identification Number
%
Percentage of Share
Capacity
Gender
HDI Status
Disabled (a permanent impairment of a physical, intellectual or sensory function resulting
In restricted or lack of ability to perform in a manner considered normal for a human being) Yes
No
Were you a South African citizen on or before 26th April 1994?
Yes
Are you actively involved in the management and the daily business operations
of the business
(Please provide a written breakdown e.g. company profile)
No
Yes
No
First Name
Surname
Identification Number
%
Percentage of Share
Capacity
Gender
HDI Status
Disabled (a permanent impairment of a physical, intellectual or sensory function resulting
In restricted or lack of ability to perform in a manner considered normal for a human being) Yes
No
Were you a South African citizen on or before 26th April 1994?
Yes
Are you actively involved in the management and the daily business operations
of the business
(Please provide a written breakdown e.g. company profile)
No
Yes
No
11. PREVIOUS CONTRACT OR TENDERING EXPERIENCE (Mark with X)
Do you have any previous contract work or tendering experience?
Yes
No
If yes, please complete the table below. List the last 2 contracts awarded to you (the tenderer) or
previous experience with other business related to the type of work or supply your are registering
for.
Employer/Department
Contact Person
Contact Number
Contract value in Rands
R
15
.
NB: All fields marked with * are mandatory. Fields marked with # are mandatory only if
applicable
Year awarded
Year completed/Still in Progress
Documentary proof attached
Yes
No
Employer/Department
Contact Person
Contact Number
Contract value in Rands
R
Year awarded
.
Year completed/Still in Progress
Documentary proof attached
Yes
No
In terms of section 37(2) of the Occupational health and Safety Act 1993 (Act85 of 1993) as
amended the mandatory (contractor) hereby acknowledges that he is an employer in his
own right. He undertakes to determine all risks associated with the work he is required to
perform and to determine and implement all cautionary measures to mitigate or remove
such risk. The mandatory will take all necessary steps to ensure compliance with the
Occupational Health and Safety Act 1993.
Where the mandatory is found not to comply with the requirements of the Occupational
Health and Safety Act the Tshwane University of Technology or its representative will be
able to stop the activities of the mandatory, without any cost to the University until such
time as the mandatory complies with the requirements of the Act.
12. CERTIFICATION OF CORRECTNESS OF INFORMATION SUPPLIED IN THIS
DOCUMENT *
I/We the undersigned is/are duly authorized to do so on behalf of the firm, hereby certify that:
1.
2.
3.
4.
5.
The information supplied is correct.
All copies of relevant information are attached.
The HDI points claimed are correct and based on owners/shareholders who are actively
involved in the day to day management of the enterprise.
I take note that payment will be effected 30 days after delivery was effected if delivered with an
original invoice.
If I am classified as a dependant service provider/labour broker as stated in the fourth
schedule of the Income Tax Act I hereby authorize the University to deduct P.A.Y.E. and
supply me with a yearly IPR 30 (only if no valid Labour Broker Certificate can be supplied).
……………………………………………………….
Signature of authorized person
…………………………………………………
Date
Personal information in block letters
Name
Surname
16
Telephone No
Capacity
ON BEHALF OF
(Supplier’s name)
Signed and sworn to before me at ………………………………..on this the …………..day of
……………………………………………20…… by the Deponent, who has acknowledge that
he/she knows and understands the contents of this Affidavit which is true and correct to the
best of his/her knowledge and that he/she has no objection to taking the prescribed oath and
that the prescribed oath will be binding on his/her conscience.
……………………………………………………………….
Commissioner of Oaths
TSHWANE UNIVERSITY OF TECHNOLOGY
Private Bag X680
Pretoria
0001
13. AUTHORISATION FOR ELECTRONIC TRANSFER OF FUNDS (EFT) TO
VENDOR’S BANK ACCOUNT
PLEASE COMPLETE IN BLOCK LETTERS
Surname/Company name
First Names/Company of Account Holder
Address
Telephone
Fax
Mobile
E-mail
Bank
Branch
Bank Account
Branch Number
Type of Account
Cheque
Savings
Transmission
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I, the undersigned hereby authorise the Tshwane University of Technology to credit my account
via EFT as afore mentioned with the amount payable/due to specified beneficiary for goods and
services rendered
Please note: That if a cancelled cheque is not attached, an official stamp should obtained from
the bank to confirm the information given above.
…………………………………………………………
Signature
………………………………………………
Date
FOR USE OF BANK (In cases where a cancelled cheque is not attached)
Above information checked and confirmed.
Signature: ………………………………………… Bank Stamp:
FOR OFFICE USE ONLY – TSHWANE UNIVERSITY OF TECHNOLOGY
Information confirmed and submitted for capturing on: ……………………………………………….
Signature: ………………………………………… Date: ………………………………………………..
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