ACC LimitedCement House, 121, Maharshi Karve Road, Mumbai - 400020 VENDOR REGISTRATION FORM ADDRESS Name of the Vendor Address of Head Office Street City State Pin Code Telephone Fax Email-id Company Web Site (if any) Name and Designation of Contact Person (s) Address of Branch (If any) Street City State Pin Code Telephone Fax Email-id Name & Designation of Contact Person Address of Factory / Factories / Subsidiaries / Sister Concerns (If any) Street City State Pin Code Telephone Fax Email-id Name & Designation of Contact Person Address of R& D Department (if any) Street City State Pin Code Telephone Fax Email-id Name & Designation of Contact Person Please use separate sheets if required 12- Mumbai . Public/Proprietorship/Partnership/Pvt.ACC Limited Cement House. Maharshi Karve Road. Yes No Yes No If Yes please furnish details. 121. Year of Establishment Name & Address of the Owner / Partners / Directors Is this company independently owned and operated whereas the Management owns at least 51% and is responsible for both daily and long-term operations? Are you declared ancilliary industry to any major industrial unit? Tick (√) below appropriate option.Ltd (Trading / Manufacturing / Representation / Commission Agents) Name of Business If you are a small-scale industry. Collaborations Details (Foreign & Local) (If any) Is this company registered to do business in India? Yes No Details of Corporate Social Responsibility (CSR) undertaken Amount Spent on CSR : .400020 ORGANIZATION DETAILS Status of Organisation Tick (√) below appropriate option. your Registration No. FINANCIAL DETAILS OF LAST FIVE YEARS Annual Turnover Rs. Sales Tax No. Excise Division Excise Collectorate CST No. Mumbai . Current Year to Date 2004-05 2003-04 2002-03 2001-02 Installed Capacity Average Monthly Production Sources of major Raw Materials Value of average raw materials inventory maintained Is Sub Vendor approval carried out by you for your vendors? . ECC No. Maharshi Karve Road.ACC Limited Cement House. PAN No. MICR Code / Bank key Bank Branch Bank Account No. LST No. Excise Registration No.VAT(TIN) Service Tax Registration No.400020 Name & addresses of your bankers. 121. Lakhs PBIT PAT Total Investment Please furnish copy of latest Income Tax Clearance Certificate SERVICE DETAILS OF ORGANISATION Describe firm’s major field(s) of Operation/Product range. Mumbai . Are you catering to the requirements of any of our Office / Works? If yes. Is your organisation certified with any Quality control body (like ISO/ISI/etc). give details. If yes. Maharshi Karve Road. . Please attach details. Please attach details. 121.400020 Make/Type / Value of machines used. Please attach details. please provide details & copies of valid certificates. Manufacturing facilities available at work place. Quality Control is responsible to whom? Name of third party inspection agency you deal with Jobs undertaken will be done at your premises or sub contracted? In case sub contracted. Do you have separate Inspection Cell? Inspection & Testing facilities available at work. At own premises Sub Contracted List of major clients with whom you are registered as approved Vendor (minimum 3 with contact persons and phone numbers including cement industries if any). name & address of sub contractor.ACC Limited Cement House. ----. Sister Concerns.. The information furnished above is correct to the best of my knowledge and belief. ….ACC Limited Cement House. R&D Centres etc) Administrative (Managers) Engineers Supervisors Workers Permanent Workers Temporary DECLARATION BY VENDOR I confirm that. (Seal of Vendor) . Branches.400020 EMPLOYMENT DETAILS (ORGANIZATION STRUCTURE) Total No. Maharshi Karve Road. Mumbai . of Employees (Including at Head Office. 121. Factories.---------------------------------(Signature of Proprietor/Partner/Chief Executive) ………………………………………………. Subsidiaries. Name (In Capital Letter) Place : ……………………… Date : ………………….