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
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Month
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Day
Year
Date
Basic Information
Section 1
1.00 Organisation Name
1.01 Physical Address
Street Address
Street Address Line 2
City
Province
Postal Code
1.02 Postal Address
PO Box Address
City
State / 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
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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 2.0 or 2.1 involved in other businesses?
Yes
No
insert their information here
2.03 Auditors Particulars
Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
-
Area Code
Phone Number
Email
example@example.com
2.04 Accounts Particulars
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
2.05
Managing Director's Particulars
Name
First Name
Last Name
ID Number
Phone Number
-
Area Code
Phone Number
Email
example@example.com
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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
Yes
No
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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Submit
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