F/PUR/01/01

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External Provider ( Supplier ) Assessment / Registration Form

(Please provide all the details locationwise / statewise / place of businesswise seperately)

A - General Information
ARN NUMBER
Provisional GST Number 27AACPW3459M1Z1
GST Return Schdule 13TH
GST Payment Schdule 22ND
Name of the Firm (As per Registration) SPARK ENGINEERING COMPANY
Type of the Firm (Prop / Pvt Ltd / Ltd / others) PROPRIRTOR
Nature of Business ( Manufatring / Trading / Service ) MANUFATRING
Year of Business Established
Name of the Chief Executive/Proprietor RAJESH WALKE
Present Turnover NA
Mobile Number ( Chief Executive/Proprietor ) 7420061370
Name of the Contact Person RAJESH WALKE
Mobile Number ( Contact Person ) 7420061370
Web Site NA
B - Contact Information
Business / Mailing Address sparkengineering@rediffmail.com
Address Line 1: PLOT NO.7, SWAMI VIVEKANAND CO.OPP
Address Line 2: IND. ESTATE, SATAV NAGAR,
Address Line 3: HANDEWADI ROAD, HADAPSAR
Address Line 4: PUNE-411028
City: PUNE 411028
State: MAHARASHTRA
Postal Code: 411028
Country: INDIA
Telephone Number:
Mobile Number: 7420061370
Fax Number:
Email: sparkengineering@rediffmail.com
C - Other Requirement
PAN NO (photocopy must)
SSI / MSME No. ( Photocopy Must )
VAT REGN. NO (photocopy must)
CST REGN. NO (photocopy must)
EXCISE RANGE (photocopy must) if MFG
EXCISE DIVISION (photocopy must)
EXCISE COMMSIONERATE (photocopy must)
IEC CODE (photocopy must)
SERVICE TAX REGN. NO (PAN BASED)(photocopy must)
ECC NO (photocopy must)
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D - Bank Details
Name of banker
Bank Account Number
Branch Name
IFSC Number
Cancle Cheque Photo Copy
E - Firm Information
Do you trade under any other name ? If yes name of the firm
Is your firm part of a large organization? If yes name of organization
Are you ISO 9001 Certified ? If Yes Certification body
Does your company work in shift systems or operate a continuous
process?
Shift & working hours
Different invoicing address? If yes, please specify
Details of Manufacturing Facility ( On hand Stock if Trader )
Inspection Method ( If Manufacturer )
Capacity to Supply Material
Lead Time Required for Supply of Material
Please specify name of the information provider
F - Required Certificate photo / Scan copy
GST Certificate
PAN Card NA
SSI / MSME NA
Cancle Cheque NA
VAT REGN. NA
G - For DYNA FILTERS PVT. LTD.
Approved Subject to following criteria
1) Past Performance ( PP ) 2) Customer Approved (CA)
3) ISO Certified (IS) 4) Authorized Dealer (AD )
5) Monopoly Supplier (MS) 6) Approved After
Assessment ( AA )
REMARKS :

Date :