PROMECH INDUSTRIES PRIVATE LIMITED

EXTERNAL PROVIDERS EVALUATION / RE-EVALUATION Ref: PUR/RI-01 Revision No:00

FORM Effective Date:01.12.2016
1. Name of the Company :

Address for Communication :

Phone Number :
E - mail address:
2. Type of Organization (Please Tick):
i. Proprietorship ii. Partnership
iii. Private Limited iv. Public Limited
3. Name of Contact Person/s :
Designation:
Office: Fax Number :
Phone Number
Residence: E - mail address :
4. Nature of Company (Please Tick) :
i. Manufacturer: ii. Distributor / Dealer : iii. Agency :
5. Year of Establishment :
6. Other Information:
Sales Tax Number___________________ Excise Range:_______________________
7. Name of the Bankers :-

Bank details :
8. List of Products / services(Use Separate Sheets if required) :

Infrasructure Details:-
9. Machines Capacity: 10. Instruments Availablity:

Date External Provider’s Signature

TO BE FILLED BY OFFICE
Forwarding Authority ‘ s Comments :-

Forwarding Authority ‘ s Signature

TOP MANAGEMENT‘S Comments:

Approved / Not Approved Signature

Re-Evaluation
Products:

Approved/Not Approved Signature