Vendor registration form

Company name:

Business Identification Number (BIN):

Street address:

General information

Company name

Entity Type *

Nature of business (select all applicable) *

Construction Goods / trades / services: (select all applicable) * N/A - Not Applicable

Consultancy services: (select all applicable) * N/A - Not Applicable

Street address *

Mailing address * Apply the same address

VAT Identification Number (VATIN) *

Business Identification Number (BIN) *

TAX Identification Number (TIN) *

Telephone (generic) *

e-mail (generic) *

Fax

Web Site *

Working languages *

Contact Persons

Contact Person *

Experience

Years experience in business. *

Annual value of total sales in EUR for the last 3 years. *

Year

List range of job values you are willing to undertake.

Min

Max

Please insert optimum contract value in a fiscal year. (Add numerical value in EUR) *

What is your average lead-in time, gear-up period (in weeks)?

What is your yearly manufacturing capacity (if applicable)?

Have you previously worked on projects for Penta or its subsidiaries in other countries? *

No Yes

Please list three of your most notable references. *

Certifications

Do you hold any quality management system certification or similar certificates? If so, please specify:

Do you have any experience working towards LEED / BREEAM accreditation? Please specify.

List any National or International trade or professional organisations of which your company is a member:

Health and Safety Measures (Mandated by law):

Health and Safety Measures (Extra):

Evidence of fatalities or health threatening injuries: *

No Yes

Please provide any additional information that you find relevant:

Promotional/reference documents

Bank Account Information

Bank name *

Branch address *

Account Name *

Account Currency *

SWIFT/BIC *

International bank account number (IBAN) *

Declaration: Below signed I solemnly declare that your future obligations should be paid to the bank account as provided above.

Date *

Place *

Name *

Position *

Signature and stamp *

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Signature

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Stamp

Personal Data Processing Principles