VENDOR
REGISTRATION
Revision 2-2010
APPLICATION
BY
Name of company (Please print): _____________________________________________
_____________________________________________________________________________
Full registered trade name (Please print): _____________________________________
_____________________________________________________________________________
Company/CC registration number: _________________________________________
MAKE A PRINT-OUT OF DOCUMENT, COMPLETE BY HAND AND SUBMIT
AS A HARD COPY TO TSHWANE UNIVERSITY OF TECHNOLOGY.
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
Supplier Database
Tshwane University of Technology
These forms must be completed in full, placed in an envelope marked clearly “VENDOR
APPLICATION”, sealed and placed in the Tender Box at the following address:
Tender Box
Supply Chain Service Centre
Unit E5, Old Mutual Industrial Park
Moot Street
Hermanstad, Pretoria
All forms to be completed in black ink only
Please PRINT so that all information is legible.
Forms that are not readable or are incomplete will be rejected.
New Application
Yes
No
If No, please supply current TUT 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
Page 2 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
-
POINTS TO REMEMBER
Revision 2-2010
-
COMPLETING VENDOR REGISTRATION APPLICATION FORM

Mandatory fields – Certain fields and documents are mandatory to certain business types only. Please
ensure that all fields mandatory to your business type 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 ensure that all data is maintained and up to date on a continual basis.
It is required from all applicants to update their detail every five years or as and when a change occurs.

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 attached and completed.

Collection points – Completed registration forms and supporting documentation can be delivered to the
address supplied herein.

Processing of registration – Your completed registration will be processed and once verified, will be
approved or rejected. The letter of confirmation of registration will be dispatched to the correspondence
details supplied on page ten. Please note that this administration process will take a minimum of 5 working
days. Once your registration has been included on the TUT Database your details will be accessible to the
purchasing officers of TUT. Formal registration as a creditor of TUT shall only be done on placement of the
first official order. A formal creditor number shall then be issued which shall have to be quoted in all future
correspondence with the University.

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 information submitted.

Queries – Should you have any queries or if you require assistance completing the registration form,
please contact the Procurement Department on Tel: 012-382 6552.

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. A vendor shall only
be allowed to register for the maximum of four (4) commodity groups.

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.
Page 3 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
PLEASE KEEP COPIES OF REGISTRATION FORM AND ALL DOCUMENTATION SUBMITTED
Name of Business
CIPRO Registration Number
/
/
Documents
required
Company
Registration
Certified
Copies
Proof of
Ownership
Certified
Copies
Proof of
Identity
Proof of
Disability
Proof of
Banking
Income Tax
Tax
Clearance
certificate
P.A.Y.E
VAT
Registration
U.I.F
Certificate
Workman’s
Compensation
Security
Officer’s
Board
Where to get documents
Business Type
Sole
Proprietor
Close
Corporation
and Private
Companies
Partnerships
Public
Company
Business
Trust
Non Profit
Organizations
N/A
Certificate of
incorporation
CK1/CK2
Partnership
agreement
Certificate of
incorporation
CM3
Trust
agreement
Certificate of
incorporation
Section 21
Registrar of Close
Corporations &
Companies
N/A
Certificate of
incorporation
CK1/CK2
Partnership
agreement
Certificate of
incorporation
CM3
Auditor’s
letter – no
shareholding
Registrar of Close
Corporations &
Companies
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
Clear copy of
Owner’s ID
doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
Trust
details:
Letter of
Authority
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
For the
company/cc
For the
partnership
For the
company
For the
Trust
For the Trust
Receiver of Revenue
(SARS)
For the
company/cc
For the
partnership
For the
company
For the
Trust
For the Trust
Receiver of Revenue
(SARS)
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
If applicable
– for security
industry
If applicable
– for security
industry
If applicable
– for ecurity
industry
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
If applicable
– for
security
industry
Clear copy
of Owner’s
ID doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
For the
owner or
the
business
For the
owner or
the
business
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
If applicable
– for
security
industry
Page 4 of 20
Clear copy of
Owner’s ID
doc.
If owner is
disabled
Bank
Statement/
cancelled
cheque
Department of Home
Affairs
Medical Practitioner
Branch of Bank where
account is held
If staff are
employed
If registered
for VAT
If staff are
employed
If staff are
employed
Receiver of Revenue
(SARS)
Receiver of Revenue
(SARS)
If applicable
– for security
industry
Security Service
Industry Regulatory
Authority
Department of Labour
Department of Labour
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
CONTACT DETAILS
Registrar of Close Corporations & Companies
The Dti campus (Block F - Entfutfukweni)
77 Meintjies Street, Sunnyside, Pretoria
Tel: 0861 843 384
Department of Labour (U.I.F certificates)
94 Church street, Pretoria
Tel: 012 337 1802
City of Tshwane/Local Authority if not based in
Tshwane
HB Phillip Building, 320 Bosman Street, Pretoria.
Department of Labour (Workman’s Compensation)
Compensation House, Cnr Hamilton & Soutpansberg Rd, Pretoria
Tel: 012 319 9111
Tel: 012 337 4000
Receiver of Revenue (SARS)
c/o Schoeman & v.d. Walt Street, P.O. Box 436, Pretoria
0001
Tel: 012 317 2000
Security Service Industry Regulatory Authority
481 Belvedere Street, Arcadia
Tel: 012 337 5500
COMMODITY GROUPS
PLEASE NOTE:
Any vendor may only register for a maximum of four commodity groups
Tick
Cat
No
Description
001
Laboratory equipment
032
002
Fasteners, Bolts,
Nuts, Rivets &
Washers
033
003
Containers &
Packaging
034
004
Bricks & Blocks
035
005
006
Canteen, Kitchen &
Cooking equipment &
Appliances
Tableware,
Hollowware &
Utensils
Tick
Cat
No
036
037
007
Sand, Soil, Cement &
Concrete
038
008
Home & Industrial
Fabrics & Textiles
039
009
Clothing, Safety
Clothing & Footwear
040
010
Cordage, Ropes,
Twines, String & Nets
041
011
Electronic
Components &
Equipment
042
012
013
014
015
Computer Hardware
& Supplies
Computer Software &
Solutions
Electric & Data Cable,
Wire &Equipment
Electric Lamps,
Lighting &
Accessories
043
Description
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
Machine Tools &
Accessories
Radio, Television,
Audiovisual &
Communication
Equipment
Pumps, Engines, Spares
& Accessories
Tick
Cat
No
063
Catering & Events
Equipment Hire
064
Engineers & Contractors
065
Castors, Ladders, Trolleys
& Wheels
066
Recreational & Sports
Requisites
067
Artwork, Crafts, Curios &
Gifts
068
Hygiene, Beauty &
Cosmetic Products
069
070
071
072
Publications, Videos &
Films, Books, Newspapers,
Magazines & Periodicals
Fresh Flowers, Plants &
Seeds
Medications &
Pharmaceuticals by
General Classification
Financial, Insurance &
Legal Services
073
Analysis, Inspection &
Evaluation Services
074
Installation Services
044
Fertilizers
075
045
Animal Feeds
076
046
Transport Vehicles,
Trailers, Motorcycles,
Boats, Aircraft & Spares
& Accessories
077
Page 5 of 20
Description
Maintenance & Repair
Services
Manufacturing &
processing Services
Cleaning Services
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
016
017
018
019
020
021
022
023
024
025
026
027
028
029
General Electrical
Equipment & Parts
Control, Process &
Measurement
Instrumentation
Test & Analysis
instrumentation
Scopes, Lenses &
Optical Equipment
Security Equipment &
Requisites, Walling,
Fencing & Gates
Signs, Nameplates,
Notices & Labels
Engravers, DieSinkers & Embossers
Insulation Products
Precious Stones and
Materials
Building requisites,
fittings & Materials
Flooring Products
Sanitary ware &
Accessories
Sewing, Knitting &
Textile Machines &
Equipment
Printing, Marking,
Engraving & Labeling
Equipment
Revision 2-2010
047
Washing, Scrubbing,
Cleaning Plant and
Supplies
078
Administration &
Management Services
048
Nails, Pins, Screws &
Staples
079
Engineering & Related
Services
080
Advertising & Marketing
Services
081
Consultants
049
050
Fuels, Petrol, Oils &
Lubricants
Coatings, Waterproofing
& Paints
051
Stationery
082
Communication, Publishing
& Printing Services
052
Steel, Pipes and Profiles
083
Consulting Engineers
084
Chemicals & Associated
Products
085
Security Services
086
Food Services
087
Computer Related Services
088
Accommodation, Tourism &
Entertainment
053
054
055
056
057
Valves and Pressure
Vessels
Pest Control and
Cleaning materials
Adhesives
Heaters and Heating
Equipment
Timbers and Timber
materials
058
Plant & Equipment Hire
089
Agricultural Services
059
Brush ware
090
Retailers & Wholesalers
060
Power Tools &
Accessories
091
Government Services –
National, Local & Municipal
030
Printing Supplies
061
031
General Foodstuffs
062
Hand Tools &
Accessories
Transport Hire &
Transport and Cartage
Services
Documents Attached
Other (Please specify):
092
Please tick box
Yes
No
N/A
Workman’s Compensation Certificate (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
Company Profile with organogram
Joint Venture Agreement/s
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.
Page 6 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
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 to be completed 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)
PRIVATE COMPANY (PTY) LTD
CERTIFIED COPY OF CERTIFICATE OF INCORPORATION
(CM 3)
CLOSE CORPORATION CC
CERTIFIED COPY OF CK1 DOCUMENT OR CK2 IF
APPLICABLE
SOLE PROPRIETOR
CERTIFIED COPY OF REGISTRATION
DOCUMENT
PARTNERSHIP
CERTIFIED COPY OF
PARTNERSHIP AGREEMENT
BUSINESS TRUST
CERTIFIED COPY OF
REGISTRATION DOCUMENT
OTHER (If Joint Venture)
CERTIFIED COPY OF REGISTRATION DOCUMENTS
Company or CC 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 *
CERTIFIED COPIES of Shareholders certificates or CC members share allocation documents must be
supplied.
Not applicable to all companies, please specify if N/A.
Did you attach your proof of shareholders documents?
Y
N
N/A
Y
N
N/A
N
N/A
1.3 PROOF OF BANKING DETAIL *
Current bank statement or copy of cancelled cheque.
Did you attach your proof of banking detail?
1.4 VAT REGISTRATION #
VAT Registration Number
If you qualify for VAT exemption, please attach confirmation of VAT exemption.
Not applicable to all companies, please specify if N/A
Did you attach proof of your VAT registration (VAT 103)?
Page 7 of 20
Y
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
1.5 P.A.Y.E. REGISTRATION #
Not applicable to all companies, please specify if N/A
Did you attach proof of your P.A.Y.E. registration?
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
Y
N
N/A
1.6 UNEMPLOYMENT INSURANCE FUND REGISTRATION #
U.I.F Number
Not applicable to all companies, please specify if N/A
Did you attach proof of your UIF registration?
1.7 WORKMAN’S COMPENSATION FUND REGISTRATION #
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 registration?
1.8 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?
1.9 DISABILITY #
Not applicable to all companies, please specify if N/A
Did you attach proof of your disability?
1.10
INCOME TAX REGISTRATION #
Income Tax Registration number
Not applicable to all companies, please specify if N/A
Did you attach proof of your Income Tax Registration?
1.11
TAX CLEARANCE CERTIFICATE *
Original of valid Tax Clearance Certificate must be supplied
Did you attach a valid Tax Clearance Certificate?
Page 8 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
1.12
CIDB REGISTRATION #
CRS Registration number
Current CIDB Grading
Not applicable to all companies, please specify if N/A
Did you attach proof of your CIDB Registration?
1.13
Y
N
N/A
Y
N
N/A
NHBRC REGISTRATION #
NHBRC Registration number
Not applicable to all companies, please specify if N/A
Did you attach proof of Registration?
1.14
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?
Page 9 of 20
N
N/A
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed 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. *
2.9 How would you like to receive your correspondence from us? *
Post
Fax
E-Mail
2.10 Correspondence Address *
City
Code
Province
2.11 Contact Person for correspondence as per 2.10
Title
Name
Surname
Page 10 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
3. SALES AND ACCOUNTS DEPARTMENT *
3.1 Sales Department #
Contact Name
Cell No
E-Mail Address
Telephone
Fax
3.2 Accounts Department *
Contact Name
Cell No
E-Mail Address
Telephone
Fax
4. CORE BUSINESS OPERATION *
(Mark with X in applicable fields)
Primary 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)
Other, please specify ………………………………………………………………………………………
…………………………………………………………………………………………………………………
5. ANNUAL AVERAGE TURNOVER *
Indicate annual average turnover excluding Value Added Tax during the past three years:
.
R
Indicate total gross asset value (fixed property excluded):
.
R
Indicate number of permanent employees
0–5
Page 11 of 20
6–50
51+
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
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?
Yes
No
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.
1. Economic Sector
2.Type of Business
Agriculture
ISO Listed
Mining and Quarrying
Manufacturer
Manufacturing
Distributor
Electricity, Gas and Water
Sales
Construction
Services
Retail, Motor trade and Repair services
Importer / Exporter
Wholesale trade, Commercial gents & Allied services
Catering, Accommodation & other trade
Repairer
Transport, Storage and Communications
Other (Please specify)
Finance and Business Services
Community, Social & Personnel services
Page 12 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
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 a 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?
Yes
No
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 (9) = Not subject to employees tax.
Yes
No
10. Are you subject to employees tax?
Yes
No
10. HDI INFORMATION *
Explanation of abbreviations used in the tables to follow:
HDI Status
Capacity
Director
D
All but white male
H
Partner
P
Women
W
Member
M
Disabled
D
Proprietor
R
Other
O
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.
Page 13 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
Note: 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 functions 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 operation
of the business?
(Please provide a written breakdown e.g. company profile)
Yes
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 functions resulting
in restricted or lack of ability to perform in a manner considered normal for a human being) Yes
Were you a South African citizen on or before
26th
No
April 1994?
Yes
Are you actively involved in the management and the daily business operation
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 functions resulting
in restricted or lack of ability to perform in a manner considered normal for a human being) Yes
Were you a South African citizen on or before
26th
No
April 1994?
Are you actively involved in the management and the daily business operation
of the business?
(Please provide a written breakdown e.g. company profile)
Page 14 of 20
Yes
No
Yes
No
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
NB: All fields marked with * are mandatory. Fields marked with # are to be completed only if
applicable
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 per commodity applied for awarded to you
(the tenderer) or previous references related to the type of goods and/or services you are registering for.
Commodity Code and description:_______________________________________________________
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Commodity Code and description:_______________________________________________________
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
Year completed/Still in Progress
Yes
No
Page 15 of 20
.
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
Commodity Code and description:_______________________________________________________
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Commodity Code and description:_______________________________________________________
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
Yes
No
Employer/Department
Contact Person
Contact Number
R
Contract value in Rands
Year awarded
Documentary proof attached
.
Year completed/Still in Progress
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/she is an employer in his/her
own right. He/she undertakes to determine all risks associated with the work he/she 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.
Page 16 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
12. SUPPLIER/TRADE REFERENCE (Mark with X)
List at least 2 current Suppliers per commodity applied for as verifiable reference.
Commodity Code and description:_______________________________________________________
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly value
Yes
No
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly value
Yes
No
Commodity Code and description:_______________________________________________________
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly value
Yes
No
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly purchases
Yes
No
Commodity Code and description:_______________________________________________________
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly purchases
Yes
No
Name of Supplier
Contact Person
Contact Number
Documentary proof attached (e.g. statement)
.
R
Approximate monthly purchases
Yes
Page 17 of 20
No
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
Commodity Code and description:_______________________________________________________
Name of Supplier
Contact Person
Contact Number
.
R
Approximate monthly purchases
Documentary proof attached (e.g. statement)
Yes
No
Name of Supplier
Contact Person
Contact Number
.
R
Approximate monthly purchases
Documentary proof attached (e.g. statement)
Yes
No
13. 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.
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 accepted 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 IRP
30 (only if no valid Labour Broker Certificate can be supplied).
4.
5.
_____________________________________
________________________________
Signature of authorized person
Date
Personal information in block letters
Name
Surname
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 acknowledged 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
Page 18 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
TSHWANE UNIVERSITY OF TECHNOLOGY
Private Bag X680
Pretoria
0001
14. 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
(attach cancelled cheque as proof)
Savings
(attach bank statement as proof)
Transmission
(attach bank statement as proof)
I, the undersigned hereby authorise the Tshwane University of Technology to credit my account via EFT
as aforementioned 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 be obtained from the
bank to confirm the information given above.
_____________________________________
Signature
_______________________________
Date
TO BE COMPLETED BY BANK
(in cases where a cancelled cheque is not attached)
Official Stamp:
Above information checked and confirmed.
Surname & initials:__________________________________
_________________________________________________
Designation:_______________________________________
_________________________________________________
Signature:_________________________________________
Page 19 of 20
TSHWANE UNIVERSITY OF TECHNOLOGY
Vendor Registration
Revision 2-2010
15. FOR OFFICE USE ONLY
FOR OFFICE USE ONLY – PROCUREMENT DEPARTMENT
Information confirmed, scheduled and submitted for approval:
Signature: __________________________________ Date: _____________________________
FOR OFFICE USE ONLY – HOD: PROCUREMENT
Vendor approved for:
Commodity Code:_______________ Description:______________________________________
Commodity Code:_______________ Description:______________________________________
Commodity Code:_______________ Description:______________________________________
Commodity Code:_______________ Description:______________________________________
Signature: __________________________________ Date: _____________________________
FOR OFFICE USE ONLY – CREDITORS DEPARTMENT
Creditor Information Validity Check completed and returned to Tender Office
Approved (mark with X):
Yes
No
Reason/s for rejection attached:
Yes
No
Signature: __________________________________ Date: _____________________________
Captured on ITS:
Creditor code: __________________________
Signature: __________________________________ Date: _____________________________
Successful Vendor applicant notified by:
E-mail
E-mail address: ___________________________________________________
Fax
Fax Number:_____________________________________________________
Signature: __________________________________ Date: _____________________________
Page 20 of 20