Vendors Form

Company Name *

Telephone *

Email *

Contact Name & Title *

Postal Code *

Company Registration Number *

VAT Reg Number *

Physical Address *

Cell Phone Number *

General Details of Services / Goods *

Date Submitted *

Website *

Other *

Valid Service Permit *

Province *

Additional Information *

Name of Product *

Average Price

Estimated Number of Services *

Contact Name *

Email *

Cellphone *

Scope of goods and work or services rendered *

Supplier’s Organisation Name *

Contact Name *

Cellphone Number *

Confirmation *

Phone