SUPPLIER / CONTRACTOR / VENDOR DETAIL FORM

MANDATORY FIELD

This field is mandatory. Please fill it before saving.

ENTER ONE TIME PASSWORD (OTP)

ENTER CODE FROM REGISTERED AUTHENTICATOR

SUPPLIER / CONTRACTOR / VENDOR DETAIL FORM

Supplier / Contractor Code *

Supplier / Contractor Name *

Business Registration No. *

Supplier / Contractor Category *

Nature of Business *

Registered Address *

Website (if available)

Parent Company (Full Legal Name if applicable)

Title of Owner (If applicable)

Tax Identification Number (TIN No)

TIN Effective Date *

No. Employees (Full time)

Tax / VAT ID (For Foreign Vendor)

Gen Bus Posting Group *

VAT Bus Posting Group *

E - Invoice Activation *

Former Engagement with Avangaad

Structure/Equity Information

	Authorized Capital	Paid up Capital *	Annual Revenue
DELETE	TEXTBOX$M~123853~ROWID~F$0$$0$N###50$N$$N$$$True$$F$0$$0$0$N$198	TEXTBOX$M~123854~ROWID~F$0$$0$Y###25$N$$N$$$True$$F$0$$0$0$N$199	TEXTBOX$M~123855~ROWID~F$0$$0$N###25$N$$N$$$True$$F$0$$0$0$N$200

Company Directors Information

	Name *	IC Number / Passport Number *	Position *
DELETE	TEXTBOX$M~123864~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$208	TEXTBOX$M~123865~ROWID~F$0$$0$Y###20$N$$N$$$True$$F$0$$0$0$N$209	TEXTBOX$M~123866~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$210

Financial Information

	Bank Name *	Address and Branch *	SWIFT Code	Bank Account Number *	Account Name *	Account Currency *
DELETE	TEXTBOX$M~121812~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$242	TEXTAREA$M~121813~ROWID~F$0$$0$Y###3600$N$$N$$$True$$F$0$$0$0$N$243	TEXTBOX$M~73010~ROWID~F$0$$0$N###12$N$$N$$$True$$F$0$$0$0$N$244	TEXTBOX$M~73004~ROWID~F$0$$0$Y###34$N$$N$$$True$$F$0$$0$0$N$245	TEXTBOX$M~121818~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$246	TEXTBOX$M~121816~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$247

List of Current Clients

	Company Name *	Company Address *	Email *	Name of PIC *	Tel No *
DELETE	TEXTBOX$M~123839~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$287	TEXTAREA$M~123840~ROWID~F$0$$0$Y###499$N$$N$$$True$$F$0$$0$0$N$288	TEXTBOX$M~121993~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$289	TEXTBOX$M~123841~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$290	TEXTBOX$M~123842~ROWID~F$0$$0$Y###20$N$$N$$$True$$F$0$$0$0$N$291

Supplier/Contractor Speciality or Scope of Supply

	Scope of Supply *	Speciality *	Other Details
DELETE	TEXTAREA$M~123844~ROWID~F$0$$0$Y###300$N$$N$$$True$$F$0$$0$0$N$342	TEXTBOX$M~1855~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$343	TEXTAREA$M~1856~ROWID~F$0$$0$N###4000$N$$N$$$True$$F$0$$0$0$N$344

Payment Terms & Credit Limit Offered

Preferred Payment Method

Documentation Checklist Details

(tick any relavent boxes)

FOR SOLE PROPRIETORSHIP / ENTERPRISE COMPANY

Cert of Incorporation / Form 9 / Section 17 (SSM)

Company Business Profile

Product Service of Offering / Catalogue

Others Certifications Licences

FOR PRIVATE LIMITED & PUBLIC COMPANY

Cert of Incorporation / Form 9 / Section 17 (SSM)

Company Profile (SSM)

Form 24 / Section 78 (SSM)

Form 44 / Section 46 (3) (SSM)

Form 49 / Section 58 (SSM)

Audited Financial Statement (Latest 3 years)

Company Business Profile

Product Service of Offering / Catalogue

Others Certifications Licences

Documentation Checklist

	SNo *	Form Name	Mandatory	Enclosure
DELETE	NUMBER$M~123919~ROWID~F$0$$0$Y###25$Y$$N$$$True$$T$0$$0$0$N$-1	LOOKUP$M~123920~ROWID~F$0$$0$N###100$Y$$N$$$False$S~124330~1~F\|[Vr Doc Master].[Company Type]\|STRING#~DF~$F$0$$6115$0$N$-1	TEXTBOX$M~123922~ROWID~F$0$$0$N###10$Y$$N$$$False$$F$0$$0$0$N$-1	ATTACHMENT$M~123921~ROWID~F$0$$0$N###4000$N$$N$$$False$$F$0$$0$0$N$426

Contact Person No.1 Name *

Contact Person No.1 Designation *

Contact Person No.1 Email *

Contact Person No.1 Mobile No *

Contact Person No.2 Name *

Contact Person No.2 Designation *

Contact Person No.2 Email *

Contact Person No.2 Mobile No *

Application Declaration

FOR AVANGAAD BERHAD INTERNAL USE :

Is a formal plant audit required? *

Is the company a potential vendor? *

Review and Evaluation

18. Authorised Personnel

	Department	Name *	Designation	Email
DELETE	LOOKUP$M~121983~ROWID~F$0$$0$N###100$N$$N$$$False$~DF~$F$0$$6049$0$N$470	TEXTBOX$M~121984~ROWID~F$0$$0$Y###100$N$$N$$$False$$F$0$$0$0$N$471	TEXTBOX$M~121985~ROWID~F$0$$0$N###50$N$$N$$$False$$F$0$$0$0$N$472	TEXTBOX$M~121986~ROWID~F$0$$0$N###100$N$$N$$$False$$F$0$$0$0$N$473

19. Business transaction

Has business transactions with Intra Oil before ?

(Please fill up the column & tick any relavent boxes)

i. Contractors are required to have a minimum of HSE Policy to qualify as a Contractor for IOS

ii. Vendors to agree to IOS's HSE policies by signing the letter of undertaking.

iii. Contractors are also required to fill up C1a

36. Health, Safety & Environment Management

a. Do you have a written HSE Policy

b. Do you have full time HSE Personnel

if Yes how many Person?

c. Does your Company have all required certifications, Authorizations and Licenses from application regulatory bodies?

if Yes please incidate in remarks column & attached Eg. Class Certification Society (ABS,BV,NKK), CIDB,PKK

Regulatory Bodies Remarks

d. Does your HSE Program includes the following work practices and procedures?

i. Personal Protective Equipment

ii. Electricity Safety

iii. Chemical Managment

if others please indicate in remarks column

E. Vendor Approval (For Office Use Only)

Recommended (1) By :

Recommended (2) By :

F. Account Code Creation (For Office Use Only)

E-Invoice Information

Supplier Company Registration No IC Passport Army

Supplier Company Registration Type

Supplier Tourism Tax No

Supplier Postal Code

Supplier Contact Number

Frequency of Billing Code

Frequency of Billing Description

Customer 1 form 9 Number

Customer Form 2 Number

Classification Description

Supplier Logistics Address

	Logistics Address	Logistics Contact	Logistics Phone Number
DELETE	TEXTAREA$M~65136~ROWID~F$0$$0$N###1000$N$$N$$$True$$F$0$$0$0$N$577	TEXTBOX$M~73697~ROWID~F$0$$0$N###240$N$$N$$$True$$F$0$$0$0$N$578	TEXTBOX$M~73698~ROWID~F$0$$0$N###240$N$$N$$$True$$F$0$$0$0$N$579

Vendor Evaluation (By Office)

Evaluation Ratings: 1: Poor 2: Fair 3: Satisfactory 4: Good 5: Excellent

Communications and Ease of Access / Response, Responsiveness to Issues (Effectiveness of Corrective Actions), Tender / Quotation Response, Expertise of Sales / Technical Support Staffs

Certified and Qualification

Co-Ordination with Class Society Surveyors, ISO 9001, 14001, 18001? Approved by Who?, Attitude to Safety / Environmental Protection, Past History Records (i.e. Posses good track records, List of clients served)

Availability of Service when required, Availability of Products and Spare Parts, Competitiveness of Price and Credit terms, Management Supervision

Quality of Delivery and the Goods (Done by Ship)

Quality of Delivery / Replacement services, Quality of the Goods / Services Provided, Working Practices, Packaging and Delivery Service, Failure to meet minimum required standard of services

Efficiency of the Service (Done by Ship)

Planning and Presentation of Schedules / Spec, Response to Additional Work or Items, Accuracy & Timeliness of Paperwork / Data (i.e. Quotes, Packing Slips, Invoices), Inventory / Facilities / Workshop / Storage

Vendor Evaluation Remarks

Reason for Blacklisting

Vendor Questionaire Details

	S No	Questionaire	Yes/No
DELETE	TEXTBOX$M~91143~ROWID~F$0$$0$N###10$Y$$N$$$True$$F$0$$0$0$N$-1	LOOKUPTEXTAREA$M~91136~ROWID~F$0$$0$N###500$Y$$N$$$True$~DF~$F$0$$4886$0$N$-1	STATIC$M~91137~ROWID~F$0$$0$N###10$N$$N$$Yes~~~Yes###No~~~No###$True$$F$0$$0$0$N$608
	01	Do you have a process flow chart / Quality Control Plan?
	02	Do you formally review customer requirements?
	03	Does the system allow for the prompt dissemination of up-to-date document and recall of obsolete documents?
	04	Do you maintain a system for recording Incoming / In-process / Outgoing inspection / results?
	05	Is the record and sample retention program adequate?
	06	Is there a Change Management Procedure to document all change & obtain customer approval prior to implementation?
	07	Do you have a comprehensive Preventive Maintenance Program?
	08	Are prescribed measures taken to identify, segregate and remove items which do not meet requirements?
	09	Do you have a “Corrective Action” system in place?
	10	Is the supplier equipped with adequate resources to perform Failure Analysis and reply customer’s complaint promptly?
	11	Is there a documented calibration & recall system for all measurement & test equipment?
	12	Do you have a Training Program in place?
	13	Is there a formal procedure to carry out the supplier survey and is there any documentation to record all approved supplier?
	14	Is there a supplier Evaluation program in place?
	15	Do you attempt to measure customer satisfaction? Does management review these measures?
	16	Are your products/materials ROHS (Restriction of Hazardous Substance) compliant?
	17	Are you able to produce the ICP Test Report, Warranty Letter and Yes No Material Safety Data Sheet upon request?
	18	Do you have a Health and Safety program in place?
	19	Do your employees have the freedom of association and right to collective bargaining?
	20	Do you have an ethical trading policy statement defining your approach to labour standards and ethical trading?

Vendor Other Details

Other Related Businesses Companies

Capacity: Work Days/Week

Manpower Distribution Resources Facilities

	Dept	Name	Designation	Contact No Ext	Email Address
DELETE	LOOKUP$M~91188~ROWID~F$0$$0$N###50$Y$$N$$$True$~DF~$F$0$$4887$0$N$-1	TEXTBOX$M~91189~ROWID~F$0$$0$N###100$N$$N$$$True$$F$0$$0$0$N$629	TEXTBOX$M~91190~ROWID~F$0$$0$N###100$N$$N$$$True$$F$0$$0$0$N$630	TEXTBOX$M~91191~ROWID~F$0$$0$N###100$N$$N$$$True$$F$0$$0$0$N$631	TEXTBOX$M~91192~ROWID~F$0$$0$N###200$N$$N$$$True$$F$0$$0$0$N$632
	Sales
	Production
	Quality
	Finance

Verified by: (Purchasing Dept)

Is a formal plant audit required?

Is the company a potential vendor?

Verified by: (Management)

Is a formal plant audit required?

Is the company a potential vendor?

OTP Verification

Two-Factor Authentication

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