REGISTRATION FORM–4 (SCRAP DEALER REGISTRATION)
REGISTRATION SR. NO.---------------------M/s. GUJARAT NARMADA VALLEY FERT. CO. LTD.
PO : NARMADANAGAR
DIST. : BHARUCH - 392 015 (GUJ.)
( STORES DEPTT.)
------------------------------------------------------------FORM FOR APPLICATION FOR REGISTRATION AS APPROVED SCRAP DEALER TO GNFC LTD.
- - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - -- - -- - -- - - - - - - - -- - - - - - - - - - - -- - -- -- - -NOTE :
( a )Complete and definite answer must be given to all questions otherwise the application will not
be considered. If the space is not sufficient, a separate annexure may be attached which must all
be signed by the same persons signing this application.
( b ) This form is not transferable.
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1.00 NAME OF THE COMPANY
:
2.00 FULL ADDRESS OF REGISTERED
:
Office / Branch with Phone No.,
Fax No, Telex No. E-mail ID. Mobile No.
3.00 NAME OF CONTACT PERSON/DIRECTOR/ :
PROPRIETOR
1)
:
2)
PHONE NO./ FAX NO./ MOBILE NO./E-MAIL
:
4.00 Is your firm -
5.00
A)
A Public/ Private limited
:
B)
A Partnership/ A Proprietor
:
C)
Any Other constitution
:
D)
Copy of constitution shall be attached
C.S.T.NO.
:
S.S.T.NO.
:
Sales Tax Form
:
ECC NO.
:
Regn No.
:
Range
:
Division
:
Commissionrate
:
PAN NO.
:
( Latest sales tax / central sales tax assessment order must be attached )
6.00 Major details of scrap lifting from various parties :
Details of scrap lifted from
( Name of Company )
-----------------------
:
Items, quantities, lifted value with
Ref.no. Of sales order/ challan
- - - - - - - -- - - - - - - - - - - - - - - - - - -
1)
2)
3)
4)
( Please attach zerox copies of sale order of the company from which materials is lifted )
7.00 DETAILS OF THE SALES TURNOVER :
( i.e. Total Value of Scrap purchased
during last 2 years )
8.00 LOCATION OF GODOWNS WITH
STORAGE CAPACITY
Rs.
:
9.00 NAME & ADDRESS OF YOUR BANKER :
10.00 DETAILS OF ITEMS IN WITCH YOU ARE INTERESTED FOR :
- - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - GROUP
MATERIAL
No.
--------------------------------------------------------------------- 1)
Metal Scraps ( Ferrous, nonferrous ) of MS/ SS/ BRASS,/
YES /
NO
COPPER / ALLUMINIUM & OTHER special materials including
Turning chips, wire etc.
2)
Various type of scrap equipments
3)
Used Empty MS Barrels / Drums of different capacity of various
Chemicals, Oil & Catalyst.
4)
5)
Scrap HDPE / JUTE Bags, Wrappers / PVC & FRP Material.
Used HDPE Carboys / DRUMS / BARRELS of various capacity
Used Refractory Materials and Chemicals
(GPCB / respective state authority pollution
control board registration is a must)
6)
Fused Lighting items such as Lamps, Chokes, Tube lights and
Other electrical items, instrument items, glass Scrap.
7)
Scrap Packing Wood. / Paper Waste.
YES / NO
YES / NO
YES / NO
YES / NO
YES / NO
YES / NO
8)
Used Rubber Hoses, Scrap Tyres & Tubes, Conveyor Belts, Sheets.
YES / NO
11.00
DETAILS OF EARLIER BUSINESS WITH
M/s. GNFC LTD., BHARUCH With copies of Sale Orders
YES / NO
12.00
I / We agree with the attached terms & Conditions for the
Disposal of Scrap items (Annex-A)
YES / NO
13.00
(A) After issuing Tender Inquiry, if you do not respond with your offer or a clear regret
letter consecutively for three tender Inquires, your registration shall be canceled which
please note.
(B) After issuing sale Order, if you do not lift the material within
permitted, your registration shall be canceled which please note.
the
time
limit
(C) Terms & Condition as per attached annexure shall be binding for all transaction
done during your registration period
(D) Parties those who were registered earlier, shall also have to get fresh registration.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -DETAIL DECLARATION TO BE MADE BY THE APPLICANT
----------------------------------------------------------------------I / We -------------------------------------------------------------------------------------------------------------------- do hereby
Declare that the entire details provide in the above application form are true to the best of my /
our knowledge and that we shall be bound by the acts of our duly constituted representative ,
Shri -----------------------------------------------------------------------who has signed this application form and of
any other person who in future may be appointed by us instead to carry on the
business of the concern whether intimation of such change is given to M/ s. GUJARAT
NARMADA VALLEY FERT. CO. LTD., BHARUCH or not.
SIGNATURE & DESIGNATION OF PERSON
WHO SING THIS FORM WITH OFFICIAL STAMP.
DATE
:
PLACE :
Filled Application form with all supporting documents with signed copy (each page) of Terms &
Condition should be posted at following address. After scrutinising the details / document if
found O.K. In all the respect, GNFC will inform you to pay registration fees.
TO,
THE CHIEF MANAGER (MATERIALS)
STORES DEPT.
GUJARAT NARMADA VALLEY FERTILIZERS CO. LTD.
PO. NARMADANAGAR - 392 015.
DIST. BHARUCH, GUJARAT