VENDOR APPLICATION FORM

Request Type
☒ New Vendor ☐ Update Address
☐ Update Bank Data ☐ Update Contact Details
Company Data
Name NEW AGE TEXTIL & MERCHANDISING E.I.R.L
Business Registration
20605875166
Number
Tax Number -
Company Type E.I.R.L
Registered Address Av. Francisco Javier Mariátegui 119
PO Box (if applicable) -
Contact Details for Purchase Orders
Name Marco Lock
Designation KAM
Telephone Number 922636480
Email Address marco.lock@newageperu.com
Contact Details for Remittance Advice
Name Marco Lock
Designation KAM
Telephone Number 922636480
Email Address Marco.lock@newageperu.com
Bank Data
Account Number (cci) 011-108-00010004450986
Account Holder Name BANCO BBVA
Account Type Cuenta corriente interbancaria
Currency Sol peruano
IBAN *Required for SEPA countries
Bank Key *Bank Code & Branch Code
Branch Name -
Branch Address -

I hereby confirm that the information provided above is true, complete and accurate, and in the event of any
additional amendments, Orica will be notified as soon as possible.

Signature

Name Lizbeth Joelli Martinez

Designation Representante Legal
Date 20 junio 2023

General
Appendix 1

Company Type Description

Corporation Corporation
Gen Partnership Gen Partnership (Ordinary Business)
Private Company Private Company ( Not Listed)
Central Govt Central Government / Government Org'n
Reg & Local Adm Regional and Local administration bodies
Central Natl Central (National) Banks
Other Dep Org Other Depositary Organizations
Other Fin Org Other Financial Organizations
State Non Fin State Non- Financial Organizations
Pvt Non Fin Org Private Non- Financial Organizations
Non Profit Org Non Profit Organizations
Individuals Individuals (“singular human beings”)
Central Govt NR Central Government (Non Residents)
Reg&Loc Adm NR Regional&Local adm bodies(Non Residents)
Central Natl NR Central (National) Banks (Non Residents)
Other Dep NR Other Depositary Org (Non Residents)
Other Fin NR Other Financial Org (Non Residents)
State NonFin NR State Non-Financial Org (Non Residents)
Pvt Non Finl NR Private Non-Financial Org(Non Residents)
Non Prof Org NR Non Profit Organizations (Non Residents)
Individuals NR Individuals (Non Residents)
Immig > 18 yrs Immigrant over 18 years - Colombia Only
Immig < 18 yrs Immigrant under 18 years - Colombia Only
Passport Holder Passport Holder - Colombia Only
Related Co Loc Related Companies (Local) -Peru Only
Related Co NR Related Companies (Non-Residents) - Peru
Universities Universities

General