Kalpataru Power Transmission Limited, India - International Divis

Instructions for filling Vendor Registration & Information Form

About this document: -

This format has been prepared to gather details of the Vendor/ Third Party to be on boarded on the rolls of KPTL. This document contains a Mai
the Vendor with the help of the following instructions:-

Definition of Public/ Government Officials:-

1. An officer or employee, regardless of rank, of any national, provincial, regional or local government agency or department (whether domestic
agencies, customs officials, local tax officials, issuers of government permits, approvals or licenses and/or immigration officials;
2. An officer or employee of any company, business or commercial enterprise or entity that is owned or controlled in whole or in part by any gov
3. A political candidate or a political party or any officer or employee of a political party;
4. An officer or employee of a public (quasi—governmental) international organization (such as the United Nations, World Bank, International M
or African Union);
5. Any private person acting in an official capacity for or on behalf of any government or public international organization (an official advisor to t
making procurement recommendations to a government);
6. Spouses, family members and close associates of any of the individuals specified above.

Former Public Official : Any person shall be categorized as a former public official for a period of three years from the date of cessation as public

Notes:
1. Items marked with asterisk sign "*" are mandatory in nature, without which filling which Vendor cannot be registered.
2. Places where information is required to be filled have been marked with grey color.
 SUB-CONTRACTOR INTRODUCTION

Name of the Sub - Contractor / Agency :

Nature of work :
Address for Communication :

Contact No :

Email ID :
Previous Company If in KPTL, Period of work Approx. Value
S. No. Name of the Job Project / Location Experience
Name WO No. Done of Work Done

Mobilisation Capacity
Mobilisation Capacity
No. Category of Labour
No. of Workmen From (Place)
1 Skilled
2 Unskilled

Sales Tax / Pan Details / GSTIN

Material Issue Basis

Consumables Tools & Tackles Safety Equipment

Referred By
Recommended By Approved By
(Planning Engineer) (Project Manager)
Area Incharge Date

Recommended for Area and Nature of work

No. of workmen required to Mobilise ( Category wise)
Required to Mobilise from

Authorized Representative Signature

Name Signature

MND

Introduction to
Time Office/IR P&M
Quality Dept. Safety Dept Stores Accounts Block Incharge
Department Incharge
 Simplified Version Of Vendor Registration & Information Form(VRIF) for Vendors based in India

Legal Name of the Vendor / Service Provider*

1. ADDRESS & CONTACT DETAILS

a) Full Address with Pin Code*
b) Office Telephone No.* Enter City Code Enter Landline / Mobile No.
0091

c) Office email Id*

d) Company Web Site (if any)
e) Contact Person (s) Details* Name Mobile E mail ID
a) Owner/CEO/Director
a) Any other designated Person
2. ORGANIZATION DETAILS
Nature of Business ( select any of these -Manufacturer, Authorised dealer/Stockist, Trader,service provider)*
a)
Status of Entity
b)
(select any one Govt/Semi Govt., Public limited, Pvt. Ltd, LLP, Sole Proprietorship / Partnership,etc)*
c) Registration Number of the entity (CIN / LLP Registration No., etc )*
d) GST No. (Provide copy of GST Registration certificate)- ANNEXURE D*
e) Permanent Account Number (Also provide copy of PAN)*
f) Are you a Small-Scale Industry Or MSMED (if yes, provide registration details). If no, please fill up the Annexure C*
g) Year of Establishment*
3. FINANCIAL DETAILS
FY ended on… FY ended on… FY ended on…
a) Annual turnover in INR Lakhs of last three years
4. CUSTOMERS' DETAILS (For similar nature of products/ services)
a) Name and contact of three major customers Customer 1 Customer 2 Customer 3
b) Name of customer
c) Contact person
d) Email Id
e) Contact Number
5. BANK DETAILS
a) Direct Payment To Bank Account Indemnity Letter - Please fill up Annexure A*
6. RELATIONSHIP TO GOVERNMENT ORGANIZATION(S) OR PUBLIC OFFICIALS* Yes/ No* Details if answer is Yes*

To the best of your knowledge, is any owner/director/partner/senior management member of your organization a Public Official or a Former Public Official?
a) If yes, please provide a list of all government offices and positions held. Indicate whether these are appointed or elected positions, and for how long the person concerned held such positions and
last date when such person left the position. *

To the best of your knowledge, is any owner/director/partner/senior management member of your organization related (by blood, marriage, step relations, current or past business
b) association or otherwise) to a Public Official or a former Public Official? If yes, please explain.
If yes, please describe the relationship and the duration between such person(s) and the Public Official(s)/Former Public Official(s). *

To the best of your knowledge, does any Public Official/former Public Official or a member of a Public Official’s/Former Public Official's family have any interest, or stand to benefit in any way, as
c)
a result of the agreement? If yes, please explain. *

7. CRIMINAL OR OTHER LEGAL PROCEEDINGS* Yes/ No* Details if answer is Yes*

Has the organisation or you or any Director/Partner/Key employee and/ or senior management member of your organization, ever been convicted under any criminal law or any other serious
a) crime in the country where the services will be rendered or in any other country (other than traffic violations)? Are there any legal proceedings of this nature pending?
Describe the charges for which the organisation or you or any key employee of your organization have been convicted or have proceedings currently pending, and when did it happen? *

8. THIRD PARTY CONFIRMATION* Yes/ No* Details if answer is No*

Are you aware of and agree to abide by the provisions of applicable laws, including but not limited to the Anti Bribery and Anti Corruption Policy of the Company and Kalpataru Supplier Code of
a)
Conduct and other related laws and regulations referred within, in providing goods and services under the proposed agreement? *

I confirm that, the information furnished above is correct to the best of my knowledge and belief.

Name :- _________________________________ (Signature of Authorized Signatory)

Place : __________________
Date: ____ /_____/_______ (Seal of Vendor)
 ANNEXURE A

Date:
To,
Kalpataru Power Transmission Limited,

Dear Sir/Madam,

Sub: Authorization for payment of bills by RTGS/ NEFT.

We hereby authorize all the entities in the Kalpataru group to directly credit our Bank Account mentioned below with the payment due
supplies/services rendered by us to all entities in the group and send us the intimation on following email address/Mobile No.:

Our Email Address: Mobile No.:

The Details of our Bank account for payment through RTGS/ NEFT are as under:
Name of Bank:____________________________________________________
Branch :____________________________________________________
Address : ____________________________________________________
MICR Code :____________________________________________________
RTGS/NEFT IFSC Code : ___________________________________________
Bank Account Number : ____________________________________________
We undertake to
1) Inform you for any changes in the aforesaid bank details.
2) Refund any wrong/excess payment of money received by us in case of erroneous transfer of funds to our account within 7 days of receip
you.
3) Inform and refund to you on any excess/erroneous money received by us.

Thanking You
Yours truly,

(Signature of Proprietor/Partner/Chief Executive)

Name in Capital letters Rubber Seal
( Please attach a copy of cancelled cheque for reference)
 ANNEXURE B
DECLARATION FORM

(A) DECLARATION ON EMPLOYMENT OF RELATIVES IN KALPATARU GROUP OF COMPANIES / COMPETITOR COMPANIES

We, hereby declare that the following employee(s) of Kalpataru group of Companies / or of Competitor Companies / are my relative(s):

Sr. Employee Code Name Designation Name of Company Location Relation

If NO, then please tick on NO

(B) DECLARATION ON ASSOCIATION IN ANY BUSINESS WITH KALPATARU GROUP OF COMPANIES / COMPETITOR COMPANIES

We hereby also declare and certify that my following relative(s) is/are associated with any type of business or have interest in business with Kalpataru Group of Companies / Competitor Companies.

Name of Associated with effect

Sr. No. Name Type of Business Location Relationship
Company from

If NO, then please tick on NO

(Signature of the Supplier Authorized Representative)

Name of Company/ies

Name & Designation of Authorized Signatory

Place:
Stamp & Seal of Company Date:
 ANNEXURE C
(Draft of MSMED Letter to be submitted by the vendor in case he is not Registered)
To be printed on the letterhead of the Vendor

Date:

Kalpataru Power Transmission Limited

101, Kalpataru Synergy,
Opp. Grand Hyatt,
Santacruz (E),
Mumbai 400055.

Dear Sir/Madam,

Sub: Declaration under Micro, Small and Medium Enterprises Development Act, 2006.

We are not registered micro or small or medium enterprise under the Micro, Small and Medium Enterprises Development Act, 2006.

We shall inform you and submit a copy of the memorandum for your records as and when we make our application for registration to the Natio
Enterprise.

Thanking You
Yours truly,

(Signature of Proprietor/Partner/Chief Executive)

Name in Capital letters Rubber Seal
 ANNEXURE D

GST REGISTRATION DETAILS

GST Registration Number (Please attach copy of Registration Certificate)

Registered Address with GSTN

Pin code
State of GST registration (include list if multiple)
Date of registration
Nature of supply (Goods / services)
Whether material supplied from SEZ / EOU (Y/N)
Whether material supplied from J&K (Y/N)
Certificate Copy attached (Y/N)
Email Id registered under GST

LIST OF MATERIALS SUPPLIED/SERVICES PROVIDED

Materials / Services Description HSN ( For Materials )

(Signature of Proprietor/Partner/Chief Executive)

D

SAC ( For Services )

Rubber Seal