SUPPLIER / CONTRACTOR / VENDOR DETAIL FORM

MANDATORY FIELD

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SUPPLIER / CONTRACTOR / VENDOR DETAIL FORM

COMPANY DETAILS

Supplier / Contractor Code *

Supplier / Contractor Name *

Registered Date

Business Registration No. *

	Supplier / Contractor Category * Mandatory

Business Type *

Nature of Business *

Year Established

Registered Address *

Mailing Address *

Country *

City

Telephone No. *

Country Code

Email Address *

Website (if available)

Parent Company (Full Legal Name if applicable)

MSIC Code

Title of Owner (If applicable)

Tax Identification Number (TIN No)

TIN Effective Date *

TIN Expired Date *

No. Employees (Full time)

Tax / VAT ID (For Foreign Vendor)

Gen Bus Posting Group *

VAT Bus Posting Group *

	E - Invoice Activation * Mandatory

State Code *

Company History

	Former Engagement with Avangaad

	Initiate EMail * Mandatory

VEN ALPH

Seq No

Structure/Equity Information

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0 Row(s)

	Authorized Capital	Paid up Capital *	Annual Revenue
DELETE	TEXTBOX$M~123853~ROWID~F$0$$0$N###50$N$$N$$$True$$F$0$$0$0$N$204	TEXTBOX$M~123854~ROWID~F$0$$0$Y###25$N$$N$$$True$$F$0$$0$0$N$205	TEXTBOX$M~123855~ROWID~F$0$$0$N###25$N$$N$$$True$$F$0$$0$0$N$206

Company Directors Information

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0 Row(s)

	Name *	IC Number / Passport Number *	Position *
DELETE	TEXTBOX$M~123864~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$214	TEXTBOX$M~123865~ROWID~F$0$$0$Y###20$N$$N$$$True$$F$0$$0$0$N$215	TEXTBOX$M~123866~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$216

Financial Information

(please provide the full banking details)

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0 Row(s)

	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$$0$0$N$248	TEXTAREA$M~121813~ROWID~F$0$$0$Y###3600$N$$N$$$True$$F$0$$0$0$N$249	TEXTBOX$M~73010~ROWID~F$0$$0$N###12$N$$N$$$True$$F$0$$0$0$N$250	TEXTBOX$M~73004~ROWID~F$0$$0$Y###34$N$$N$$$True$$F$0$$0$0$N$251	TEXTBOX$M~121818~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$252	TEXTBOX$M~121816~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$253

List of Current Clients

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0 Row(s)

	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$$0$0$N$293	TEXTAREA$M~123840~ROWID~F$0$$0$Y###499$N$$N$$$True$$F$0$$0$0$N$294	TEXTBOX$M~121993~ROWID~F$0$$0$Y###50$N$$N$$$True$$F$0$$0$0$N$295	TEXTBOX$M~123841~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$296	TEXTBOX$M~123842~ROWID~F$0$$0$Y###20$N$$N$$$True$$F$0$$0$0$N$297

Supplier/Contractor Speciality or Scope of Supply

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0 Row(s)

	Scope of Supply *	Speciality *	Other Details	Count
DELETE	TEXTAREA$M~123844~ROWID~F$0$$0$Y###300$N$$N$$$True$$F$0$$0$0$N$348	TEXTBOX$M~1855~ROWID~F$0$$0$Y###100$N$$N$$$True$$F$0$$0$0$N$349	TEXTAREA$M~1856~ROWID~F$0$$0$N###4000$N$$N$$$True$$F$0$$0$0$N$350	NUMBER$M~23979~ROWID~F$0$$0$N###25$N$1$N$$$True$$T$0$$0$0$N$362

Payment Terms & Credit Limit Offered

Credit Limit

Credit Term Days

	Preferred Payment Method

Documentation Checklist

0 Row(s)

	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$432

Contact Details

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

Name *

Position *

Date *

Vendor Declaration Form

1. I/We acknowledge that I/we are fully aware of Avangaad's(which shall mean Avangaad Berhad and/or its group of companies) corporate governance policies which include the Anti-Bribery Management Systems ("ABMS") Policy and Whistleblowing Policy (hereinafter collectively called "the Policies", the definition whereof shall refer to the existing as well as any updated versions thereof from time to time).

I/We confirm that I/we have received and reviewed the Policies.

2. I/We am/are the contractor / vendor / supplier / agent / consultant / customer / Intermediary (*) / Third Party (*) of Avangaad.

3. I/We hereby declare that the Policies have been communicated to me/us in accordance with the requirement of ABMS and I/we understand and agree that the Policies are applicable to me/us with regards to my/our business relationship with Avangaad.

4. As such, I/we hereby agree and undertake that in all and any of our business dealings with Avangaad, I/we shall:

a. Comply and ensure that all my/our affiliates, agents, employees and/or sub-contractors will comply with the provision of the Policies;

b. Uphold and comply with all relevant laws that prohibit acts of bribery and corruption ("the relevant laws"); and

c. Not act, or omit to act, nor cause an agent and/or employees of Avangaad to act, or omit to act, in any such way that would be in violation of the policies.

5. I/We undertake to promptly inform Avangad of any breach and/or alleged/suspected breach as aforesaid and I/we undertake to cooperate with Avangaad in any investigation of such breach involving Avangaad's staff.

6. I/We acknowledge that the provisions set out in this declaration form shall form part of the terms and conditions of my/our appointment and/or contract of service.

7. I/We further acknowledge and agree that Avangaad has the right to suspend or terminate the contract / agreement / job and/or disqualify me/us from tendering for future contracts / jobs if I/we were found to have breached the aforesaid requirement or any other terms and conditions implemented by Avangaad pursuant to the contract / agreement / job.

(*) As defined in the ABMS

Name

Name of Company

Designation

Date

Sign Click to Sign

FOR AVANGAAD BERHAD INTERNAL USE :

Conclusions (Review and Evaluation)

	Is a formal plant audit required? * Mandatory

	Is the company a potential vendor? * Mandatory

Name

Designation

Date

Remarks

Final Approval (COO/CFO)

	Approved * Mandatory

Recommendation

Remarks

Approver Name

Approver Position

Approved Date

OTP Verification

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