Name of Company

Registered Address

City

State

Country

Telephone

Fax

Email

Website

Branch Office(s) Address/Telephone

Company Type --- Select --- Sole Proprietorship Partnership Limited Liability Company

CAC Registered? --- Select --- Yes No

Type of Supplier --- Select --- Subcontractor Supplier

Company Name

Company Reg No

Issued & fully paid share capital (if applicable)

Name and Residential address of Directors/Partners (Where applicable)

Name of Banker

Date of last audited account

If audited account not available, please give reasons

State maximum value of a single contract ever handled by your company, with the name of the client and date executed

State the total value of three major projects previously executed or currently being executed by you in the last one year

Client	Value of Supply (=N=)	Date Completed

Maximum value of contract your company can handle before payment is made

Name of three referees all of who must be similar organization for whom you have executed projects

Name	Address

Service areas e.g. Civil, Electrical etc Plumbing Materials Reinforcement Wood Cement Sand/Granite Electrical Materials Aluminum products

Any other areas, please specify

Coverage Area e.g. Lagos, Abuja, Kano, etc or Nationwide

Indicate Category --- Select --- A is up to but not exceeding =N=100,000.00 B is up to but not exceeding =N=500,000.00 C is up to but not exceeding =N=1,000,000.00 D is up to =N=1,000,000.00 and above

Any other information that you consider relevant or wish to provide?

Name

Address

Phone Number

Email Address

A copy of your VAT Registration Certificate Max file size: 5Mb (pdf/jpg)

A reference letter from your Bank Max file size: 5Mb (pdf/jpg)

Photocopy of utility bill Max file size: 5Mb (pdf/jpg)

One cancelled blank cheque Max file size: 5Mb (pdf/jpg)

Last Audited/Management Account Max file size: 5Mb (pdf/jpg)

3 reference letters from three of your former clients Max file size: 5Mb (pdf/jpg)

Valid ID of contact person (e.g driver's license, passport, National ID) Max file size: 5Mb (pdf/jpg)

Passport photograph of Sole – Proprietor, Partner or Director Max file size: 5Mb (pdf/jpg)

TERMS AND CONDITIONS AGREEMENT TERMS AND CONDITIONS AGREEMENT I/We hereby apply to be registered as a supplier/subcontractor to your organization, and have indicated in the attached form the area of operation, category and coverage area. I/We agree that our registration does not in any way guarantee that any job/contract will be awarded to us by the company and that the company can where it deems fit place any of its work on an open tender, where un-registered and registered vendors may bid freely. I/We agree that supplies made or work undertaken will be subject to statutory deductions at the point of payment, and that the correct details have been entered in respect of Company registration number and VAT number. BCL will not be liable to any claims whatsoever in the case of errors on payments being made, which may have been as a result of inaccurate information provided to BCL. I/We declare that information contained in the application form is true and correct to the best of my/our knowledge. We understand that the company has the discretion to disqualify us or cancel any contract awarded to us if any such information given about myself/ourselves is discovered to be false. I agree and accept to the terms and conditions.