FormatNo4411008.docVIP

Format No 46102F04 1/4 BHARAT PUMPS COMPRESSORS LTD. NAINI, ALLAHABAD – 211010 FAX : 2687075 ; PHONE : 2687412-15 Email: bpcIndia@sancharnet.in VENDOR REGISTRATION APPLICATION Date: - Page 1 of 4 For B.P.C.L. Use For B.P.C.L. Use CATEGORY CODE DESCRIPTION Vendor Code Date ofRegistration Date ofDeletion Introductionby Valued by Date The portion below is to be filled in by the vendor Name of the vendor full:- Address Telephones(s) Email, Fax Telegram Person(s) to be contacted(Name and designations) OFFICE Address for sendingPurchase order / chequesetc. (Pl. Tick) Office Works Weekly offfor works Items Manufactured / Service Offered Items / Service Interested in supplying / offering to BPCL Cont. p. /2 Format No 46102F04 2/4 Type of company (Pl, Tick) Type of industry (Pl, Tick) Pvt. Ltd. Public Ltd. Small Scale Large Scale/ Proprietary Partnership Govt. Public Sector Contractor Registration number (whichever is applicable) TAXES AND DUTIES Small scale Industries Directorate of Industries Date of commencement of MFG C.S.T. No. S.T. No. Total capital employed Rs. Excise dutyApplicableYES / NO Details of Directories Annual Sales Turnover for last three years Name Qualification ExperienceYrs. Year 200 - 200 200 - 200 200 - 200 Business Commenced with BPCL Name Address of Bankers Year Name of the Depts Dealt with Bank Account No. Name and Address of associate companies other manufacturing units BPCL Vendor Code Items MFD / DEALT Cont. p. /3 Format No 46102F04 3/4 Production Facilities Shift worked / day (Pl. Tick) One Two Three Total manpower employed Managerial Supervisory Office Staff Work man Total floor space in sq. mts. Covered Uncovered Details of Machinery, Instruments an