Ref No: IMS-ADM-09

Issue / Rev No. : 01/00

Date : 03.11.2018

Vendor Evaluation Form

1 Name of the Vendor :

2 Contact Person :
Organization Type :

Proprietary Partnership Pvt Ltd

3
Public Ltd Corporate

Nature of Business :
Service Provider Authorised Agent Trader
4
Others

Vendor Address :
:
5
:

6 Land line No. :

7 Mobile No. :
8 Fax No. :
9 Website :
10 E-mail :
11 Statutory Details
12
13
Declaration :
I / We (Name of Partner/ Proprietor or shareholder) do hereby
declare that the entries made in this application form are true to the best of our
knowledge and that we shall be bound by the acts of duly constituted attorney.

Signature with Seal :

Date :

For Acsys Use

PAGE 1 OF 2

Ref No; IMS-ADM-09 Internal

 Ref No: IMS-ADM-09
Issue / Rev No. : 01/00
Date : 03.11.2018

Vendor Evaluation Form

General Information Remarks

Does the company have any current YES NO NA
1 plan to change the ownership of part /
entire company?
YES NO NA
Does the company have any holding
2
with competitors of Acsys ?
YES NO NA
Does the company have dedicated
3
employees working for / with Acsys ?
YES NO NA
4 Payment Terms is suitable for Acsys.

Will the company be able to provide the YES NO NA

5 same price & service for small volume
runs as well as large?
YES NO NA
Does the company have customers in
6
the same industry as Acsys?
YES NO NA
Does the company comply with Legal
7
and Statutory Regulations?

Vendor Approved : Yes / No

Date : Signature:
___________________

PAGE 2 OF 2

Ref No; IMS-ADM-09 Internal