FAUJI CEMENT COMPANY LIMITED (Form for the registration as contractor/supplier/vendor) 1. Name of Applicant 2. NIC No Pur-F-1 Personal Biodata (Part I) 3. Nationality: Pakistani Non-Pakistani 4. Resident Status Resident Non-Resident 5. Passport No. (For Foreign Nationals only) Contact Data ( Part II) 6. Residential Address: 7. Business Address: 8. Email Address: Mobile: 9. Phone No.(Office) Fax, No: 10. Addresses of the branch offices (with Phone & Fax Numbers) a) b) c) d) 11. Business Name Business Data (Part III) 12. Principal Business Activity 13. Brief Business Description Manufacturer Services Others 14.Corporate Status Sole Proprietorship Partnership Limited Company Other (write detail)
15. Please list down the foreign Principals with whom you are working as authorized Agent or otherwise dealing with their products. a. (Authorized Agent / Dealer / Distributor / Seller b. c. d. Note: (You may attach a separate list if more space is required.) 16. Duration of Association with Principals 17. Status of Association Authorized Agent Distributor Dealer Re-Seller (Attach proof of status) 18. Particulars of Partners (Names, NIC No. & Contact No.) i) ii) iii) NTN No GST No Documents to be attached with the application form Part (IV) Brief profile of the company (beside other thing include year of establishment, Organizational hierarchy, number & locations of office(s) etc. Bank certificate or bank statement for last six months. Photocopy of National Income Tax registration certificate. Details of tax paid during the last two years GST registration certificate. Details of the experience in the field & any specific expertise. Services / stores which the firm can provide. Photocopies of pre-qualification certificates of other companies if registered. Undertaking on Rs.20/- stamped paper that the owner of the firm has not been black listed by any other company / department. Copy of certificate of membership with chamber of Trade and Industry.
Registration Fee (Part V) A non-refundable fee of Rs.1,000/- will be paid for registration through bank draft or pay order in the name of Fauji Cement Company Ltd. Security (Part VI) If required, will you be willing to deposit security, earnest money, Arrange Bank Guarantee, insurance cover & Performance bond etc. Yes / No. List of the categories (Part VII) Indicate the categories in which you desire to be registered by putting a in the box provided for the purpose. Categories are as under: 1. B u ild in g a n d c o n s tr u c tio n m a te r ia l 2. O th e r M e ta llic I te m s S h e e ts M S A n g le Iro n M S R o d (S a ria ) M S F la t S trip M S C h a n n e ls M S G ird e rs C o rru g a te d S h e e ts C h e q u re d P la te s 3. Hardware, Pipes & Fittings 4. Oils & Lubricants SS Pipes MS Pipes 5. Bearings & Related Parts Seamless Pipes Fittings 6. Testing & Calibration Equipments Teflon Rods/sheets 7. Air Conditioners/Refrigerators/ Parts S S S h e e ts S S R o d s B ra s s S h e e ts? S h im B ra s s R o d s C o p p e r S h e e ts C o p p e r R o d s B ro n z e R o d s A lu m in iu m R o d s B e lz o n a (s u p e r m e ta l) H a rd o x S te e l 8. Rubber & Polymer Products 9. Tools & Workshop Machinery Various rubber/polymer parts Power & Hand Tools Vulcanizing Material Workshop Machinery Plastic & PVC parts 10. Hydraulic/Pneumatic Equipment 11. Fluid Control Components Compressors & parts Valves Pumps & Parts Gauges Blowers & Parts Industrial Filters Gauges 12. Filter Bags/Air Slide/ Other Cloths 13. Rubber Belt Conveyer Filter Bags Imported Belts Air Slide Cloth Local Belts Pneumatic Polyester Fabric Cloth Heat resistant Cloth
14. W elding M aterials 15. Engineering W orks W elding Equipm ent Fabrication Electrodes all types C asting Hard Facing W ire Forging O rdinary Nuts/Bolts 16. V-B elts/fan B elts Special N uts/bolts Im ported Local 17. M echanical Parts Im ported 18. Seals A ll T ypes Local Im ported Rubber Seals Local R ubber Seals 19. C arbon B rushes M echanical Seals Im ported Felt Seals Local 20. Electrical Item s 21. E lectronics For Industrial U se Instrum ents For General use PLCs Electrical M otors C ontrol System s Transform er all types Sensors Insulators Electronic C om ponent C ards W ire/cables all types 22. H oists/c ranes Electric Hoists M ono R ails Overhead C ranes Industrial Elevators 23. R efractories Im ported Bricks Im ported Castables Local Bricks Local C astables Insulation Blocks 24. Laboratory E quipm ent 25. C hem icals/g ases A pparatuses/equipm ents Industrial Chem icals G lass ware Industrial Gases Lab Chemicals 27. Stationery/Printing 26. O ffice E quipm ents Stationery Photocopiers/parts Printing Fax M achines Telephone Sets 28. Packing M aterial Exchanges/Parts/C ards Paper Bags UPS Laminated PP Bags C om puters & related accessories 29. Raw M aterials 30. C oal Gypsum Im ported Leteriate ( Iron Ore ) Local 31. M iscellaneous Insulation M aterials Technical Books Grinding M edia Fire Fighting, Safety & Security Equipm ents General Supplies
IF YOU WANT TO TELL ANY THING MORE, MAKE USE OF THIS SPACE Signature of applicant Name Designation Date
For Office Use Only Recommendations Recommended / Not Recommended President: Members: 1. 2. 3. 4. 5. Approved: Date: