NEW VENDOR SELECTION FORM

Proposed by: ………………………….Dpt Vendor Code

1 COMPANY NAME :
2 COMPANY AFFILIATE/GRO:
3 ADMINISTRATIVE ADDRE:
Post Code :
Telephone No : Fax no Country:
Email address : City

4 CONTACT PERSON : Name: HP: Web Site :

5 CURRENCY :

6 NPWP NO :
7 VAT COLLECTOR ( Yes / : Date: / /

8 LONG OF SERVICE TO : 0 Years Started when / /

SCHENKER
9 PRODUCT / SERVICES :
TO SCHENKER 1
2
10 ESTIMATED LEAD TIME T: 0 Days Estimated Lead : Days.
PROCESS time for Delivery
11 COMPANY OFFICE HOUR : Hour Days

12 MODE OF GOODS DELIVE:

Others
13 PRODUCTS WARRANTY A:
AFTER SALES SERVICES
14 AVAILIBILITY OF BACK UP:

PRODUCTS UNDER RUSH ORDER

15 CERTIFICATION ( ISO, etc: Certificate no: Date:
Certificate no: Date:
16 CUSTOMER'S REFERENC:
17 OTHERS ( If Any ) :

Executed by Vendor

19 TERM OF PAYMENT : 60 days

20 BANK DETAILS

IDR ACCOUNT NO : Bank Branch:

BANK ADDRESS : Beneficiary :
SWIFT CODE :

USD ACCOUNT NO : Bank Branch:

BANK ADDRESS : Beneficiary :
SWIFT CODE :

Declaration: Name: Company Chop :

All data mention above are correctly presented by
the Company authorised person:
Signatures:
We will be faithfull to SCHENKER Regulation related to
Labour, Environmental issues, and Health and Safety

Reason to Select this Vendor

………………………………………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………………..

Proposed by Approved by Approved by Approved by Approved by Acknowledged by

Manager Controlling & Comlpiance QHSSE HOD Director or President Director Finance & ACC dept

Date: Date: Date: Date: Date: Date:

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