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| ISSUE 2000 |
Section 1: Company Details and General Information
1.
Name
of Company/Institution (full legal name):
2. Street Address: 3. Mailing Address:
City:
Country:
4. Tel (include country and area codes): 5. Fax (include country and area codes):
6. Email: 7. WWW Address:
8. Contact Name and Title:
9. Ownership and Parent Company (full legal name):
10. Name and Address of Subsidiaries, Associates and/or Overseas Representative(s) (attach a separate sheet if necessary):
11a. Nature of Business (please tick one box in each section):
Manufacturer: Trader: Authorised .Agent:
Consulting Company: Other (specify):
11b.Type
of Business
Corporate/Limited: Partnership: Gov. Agency: Other (specify):
12. Year Established (under the name shown in 1): 13. Number of Full-time Employees:
14. Licence N°/State Where Registered: 15. VAT N°/Tax ID if any:
16. Technical Documents Available in:
English French Spanish Russian Arabic
Chinese Other (specify)
17. Working Languages:
English Somali Arabic Other (specify)
Section 2: Financial Information
18. Annual Value of Total Income for the Last 3 Financial Years:
Year ______: USD ___________ million Year ______: USD ___________ million Year ______: USD ___________ million
19. Annual Value of Export Sales for the last 3 Financial Years:
Year ______: USD ___________ million Year ______: USD ___________ million Year ______: USD
20. Bank Name/Money Vendor Swift/BIC Address:
Address:
21. Bank Account N°: Account Name:
22. Please provide a copy of the company's annual or audited financial report of the last 2 years.
If available, please provide credit rating by Dun and Bradstreet or equivalent (specify which).
Section
3: Technical Capability and Information on Goods / Services Offered
23. If available, Quality Assurance Certification, e.g. ISO 9000 or National Standard. Provide a copy of your latest certificate.
24. International Offices/Representation (countries where the company has local offices/representation):
25. For goods only, do those offered for supply conform to National / international Quality standards?
Yes No
List below a maximum of your core goods offered:
Description of Goods (one line for each item) Delivery Locations Quality Standard (if applicable)
Section
4: Experience
26. Annual Value of Total Sales for the last 2 Years:
Year ______: USD___________ Year ______: USD___________ Year ______: USD___________
27.
Annual Value of Export Sales for the last 2 Years:
Year ______: USD___________ Year ______: USD___________ Year ______: USD___________
29. Recent contracts with the UN (see Note1) and/or other international aid organisations (attach a separate sheet if necessary). Please provide documentary evidence of such contracts as required, e.g. copies of purchase orders.
Organisation Value Year Goods/Services Supplied Destination Country
USD
USD
USD
30. To which other countries have your company imported from over the last 3 years, if any?
Section
5: Other
31. Please list any disputes your company has been involved in with UN Organisations over the last 3 years:
32. List any national or international trade or professional Organisations of which your company is a member:
33. Certification:
I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes details will be provided as soon as possible.
Name Functional Title
Signature Date
The legal agreement between the supplier and the organisation within the UN System shall be defined in the purchase order/contract and any associated contract(s) between the supplier and the UN organisation. Information provided to the supplier in association with the registration is provided for reference only, and in no case shall take precedence over terms in the purchase order/contract or the associated contract(s).
Please be informed that the United Nations has decided not to do business with companies or any of their affiliates or subsidiaries, which engage in any practice inconsistent with the rights set forth in the convention on the Rights of the Child, regarding certain protection applicable to children performing work, or engage in the sale or manufacture of anti-personnel mines, or any significant component produced primarily for the operation thereof.
Interested potential suppliers should send their response including above documentation to one of the following addresses or by email (max 3.5MB) to procurement.so@undp.org
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UNDP sub-office in Hargiesa Mr. Balma Yahya Head of Sub-office Hargiesa |
UNDP sub-office in Garowe Mr. Aziz Ahmed Head of Sub-office Garowe |
UNDP Liaison office in Nairobi Mr. Sergio Valdini Deputy Country Director (Operations) - UNDP Somalia Springette, Spring Valley, Off Lower Kabete Road, P.O. Box 28832, 00200 Nairobi, Kenya
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