CMTi - Supplier Application Form

Supplier Application Form

This is an application form to become registered on CMTi Consulting's Supplier Database ALL INFORMATION WILL BE TREATED CONFIDENTIALLY AND WILL NOT BE DISCLOSED TO ANY 3RD PARTY
Date

MonthDayYear
Date
Basic Information

Section 1
1.00 Organisation Name
1.01 Physical Address

Street Address

Street Address Line 2

CityProvince

Postal Code
1.02 Postal Address

PO Box Address

CityState / Province

Postal / Zip Code
1.03 Nature of Business
1.04 Holding Company or Major Shareholder
1.05 Income Tax Number
1.06 VAT Number
1.07 Bank Account Details

Basic Information

Section 2
2.00 List of Directors
2.01 List of Shareholders (does not apply to listed companies)/Members/Partners/Other
2.02 Are any of those listed in 2.00 or 2.01 involved in other businesses?

YesNo
insert their information here
2.03 Auditors Particulars
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Email
example@example.com
2.04 Accounts Particulars
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
2.05 Managing Director's Particulars
Name

First NameLast Name
ID Number
Phone Number

Area CodePhone Number
Email
example@example.com

Basic Information

Section 3
3.00 Please upload an original Blank Cheque or original stamped letter from your Bank, verifying the banking details you have provided. Any changes to your info will require the same.

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3.01 Please upload Company Registration Documents. In the case of a Public Company, please upload latest published Financial Statements

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3.02 Please upload certified copies of the ID Documents of all Directors/Owners/Members/Shareholders

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3.03 Please upload VAT Registration Document

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3.04 Please upload valid Tax Clearance Certificate

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3.05 Please upload Safety Documentation: Letter of Good Standing COID, Medical Fitness Certificate issued by the Occupational Health Doctor (dated within last 24 months), Basic Risk Assessment, other applicable permits or registration certificates

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3.06 Please upload any registration certificate pertaining to your particular industry, e.g. ECB (Electrical Contractors Board)

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3.07 Does your annual turnover exceed R 5 Million

YesNo
If turnover exceeds R 5 Million please upload a valid B-BBEE certificate obtained from an accredited verification agency or registered auditors approved to supply such certificates by the IRBA

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If turnover does not exceed R 5 Millon, the Exempt Micro Enterprise should please upload a letter signed off by an auditor or a certified accounting officer certifying turnover and confirming ownership of the company

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3.09 Please upload a Current Utility Bill (Public Companies are exempt)

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3.10 Please upload a Declaration of Interest

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3.11 Please upload a Non-Disclosure Agreement

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3.13 Please upload a CSDB Registration (alternatively a waiver of the resolution at Directors discretion)

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Should be Empty:

Supplier Application Form

Basic Information

Basic Information

Basic Information