VENDOR REGISTRATION FORM - REGISTERED COMPANY

OWNER/S OF BUSINESS (Full name as reflected on ID Document)

Please complete for the owner of business.

Title ( Mr, Mrs, DR)

Name

Surname

ID Number

COMPANY DETAILS
Please Complete using CIPC document and tax clearence certificate information.

Registered Name

Trading Name

Situated in:

Port Elizabeth

George

Company Reg Number

Income Tax Number

VAT Number (If Applicable)

BUSINESS ADDRESS (PHYSICAL)

Street Name:

Number

Suburb

Postal Code:

City:

PO BOX Details:

BUSINESS ADDRESS (POSTAL)

Same As Above:

Yes

Street Name:

Number

Suburb

Postal Code:

City:

PO BOX Details:

CONTACT PERSON

Daily contact name

Position

Telephone

Fax Number

Cell Number

Email Address

CERTIFICATION AND SUPPORTING DOCUMENTS

BBBEE Status

Please submit information from your official valid SANAS BEE certificate.

Level of Contribution:

Percentage Contribution:

Compliance

Tax Clearance

COIDA Certificate

License to carry on a business (if applicable) (Businesses Act 1991) CIPC

Business Reg documents

Acceptability of food premises (if applicable)

PLEASE NOTE AT THE TIME OF ENTERING INTO ANY AGREEMENT WITH THE UNIVERSITY YOU WILL THEN BE REQUIRED TO PROVIDE VALID CERTIFIED COPIES/ORIGINALS OF THE RELEVANT DOCUMENTATION LISTED ABOVE.

CATEGORY

Please select the industry category that best suits your type of business. You may register in a maximum of 3 sectors.

Please provide detailed description within the category

SUPPORTING DOCUMENTS

Please feel free to upload any additional information pertaining to your business. Images or pictures, company profile, business plans etc. This will help us to better understand your business and product offerings.

GENERAL COMMENTS

Please use this space to add any other information you feel may add value to your registration

DECLARATION OF INTEREST

In order to give effect to the above the following must be completed:

No, I am not connected to any Employee(s),Council Members and/or Officials associated with the Nelson Mandela University

Yes, I am connected to either an Employee(s),Council Members and/or Officials associated with the Nelson Mandela University

By submitting this form you agree to the terms and conditions mentioned in the Corporate governance

I, hereby certify that I have the authority to submit this application and all the information contained herein is accurate and true as at the date of submission. I understand that by submitting this form, this in no way guarantees me any future business with the Nelson Mandela University and it is merely a process to submit the necessary company information

Commercial Services

BBBEE Status

Compliance

Scroll over for the explanation:

Please ensure you list all possible connected people in the spaces provided below