SUBCONTRACTOR
APPROVAL FORM
Supplier 
Subcontractor

Annual Review:

New/Proposed:

Northfields WA Pty
Ltd Contact:
Company Name:
Address:
Postal Address:
Company Contact:
Telephone:
Fax:
Mobile:
Email:
GST Registered:
* mandatory
ABN No:
* mandatory
ACN No:
Payment Terms:
30 Days
Preferred method of * complete bank details if EFT
payment:
Trade Code:
* office use only
Client Nominated:
Yes
No
Acceptance Criteria:
Quality Assurance:
AS/ISO Accredited
Yes
No
Or Internal quality policies:
Yes
No
Demonstrable good history: Yes
No
Customer Nominated:
Yes
No
Licensed / registered Trade : Yes
No
Sole Supplier:
Yes
Insurance: * Copies of certificates required
Public Liability:
Workers Compensation:
Professional Indemnity:
Portable Long Service leave:
Superannuation Fund Name:
No
Cert. No:
Copy Attached:
Subcontractor Only:
References:
Company name:
08/08/2012
Details:
Expiry Date:
Expiry Date:
Expiry Date:
Reg No:
No:
Contact:
Page 1 of 3
Phone:
FA-00-F-018
Company name:
Company name:
Contact:
Contact:
Phone:
Phone:
NOTE: Subcontractor must be approved prior to placing order. This form is to be filed in accounts
when the above section is completed. (Minimum of 2 elements of the Acceptance criteria to be met).
References: Min: 2 Checked & Confirmed:
Company/Contact: Notes:
Signed
Dated
Signed
Dated
Signed
Dated
Northfields WA Pty Ltd History: Brief Notes/Comments:
Signed
Dated
Submit By: _____________Project No: ___________________ Date: ___________________
Signed approval General Manager: ______________________________________________
Accounts use only
08/08/2012
Page 2 of 3
FA-00-F-018
(Add) Entered By: _______________________ Date: ____________________
(Delete) Entered By: __________________________ Date:____________________
ELECTRONIC FUNDS TRANSFER
We request that all payments by Northfields WA Pty Ltd for goods and / or services supplied by us pursuant to
existing contract(s) be directed to the following Bank Account.
Financial
Institution
Branch
BSB Number
Account
Number
Account Name
Your Fax
Number
Bank Address: _________________________________________________________________________
We acknowledge and agree as follows:





Northfields WA Pty Ltd is under no obligation to verify the correctness of the Bank Account details.
Any changes in any of the details must be notified to Northfields WA Pty Ltd in writing.
Northfields WA Pty Ltd will not be responsible for any delays in payment or error due to factors outside the
reasonable control of Northfields WA Pty Ltd (including but not limited to delays or errors in the banking system).
Northfields WA Pty Ltd reserves the right at any time to terminate or suspend this direct credit payment method
and to pay by cheque or any other manner which Northfields WA Pty Ltd may determine from time to time.
If Northfields WA Pty Ltd makes an incorrect payment to the above, this Bank Account shall repay those monies
to Northfields WA Pty Ltd immediately upon written notification by Northfields WA Pty Ltd.
Position:
Telephone:
Name:
E-Mail:
Signature:
Date:
Example Only:
Financial
Institution
Commonwealth
Bank
Branch
BSB Number
Account
Number
Account
Name
Your Fax
Number
Bunbury
066-507
1234 5678
Hamish McBeth
(08) 9721 1234
To be completed by Northfields WA Pty Ltd
References: Checked and Confirmed
Company/Contact:
Notes:
Primary reason for New Supplier/Subcontractor establishment:
Submit By: _____________________ Project No: _________________________ Date: ______________________
Signed approval General Manager: _________________________________________________________________
Accounts use only
(Add) Entered By: __________________________________
08/08/2012
Page 3 of 3
Date: ________________________
FA-00-F-018