供应商调查表(中英对照)

PREQUALIFICATIONFORMFORSUPPLIERS/CONTRACTORS供应商调查表Page2of16A)PARTICULARSOFTHEFIRM企业概况1.NameoftheFirm公司全称:2.RegisteredAddress注册地址:3.MailingAddress邮寄地址:(Ifdifferentfrom2)4.TelephoneNo.电话:5.FaxNo.传真:6.Web-siteAddress公司网址:7.E-mailAddress电子邮件:8.TypeofCompany公司性质:Public/Private/Partnership/SoleProprietor/JointVenture/Others(Pleasespecify)国营/私营/股份制/独资/合资/其他（请列出）9.CountryofIncorporation国家:10.RegistrationNo.营业执照号:11.DateofRegistration/Incorporation注册日期:NB:ToattachacopyofthelatestBusinessInstantInformationfromRegistryofCompanies请附上最近的公司登记情况表12.RegistrationwithProfessional,TradeorQualityControlOrganisation,boardand/orAssociationetc.在有关专业团体，贸易机构和质量控制机构的登记证书Page3of16:(Pleaseattachacopyofthecertificateofregistration请附上营业执照附本)13.OtherAffiliations,SubsidiariesorJointVenture(withindicationof%owned)其他从属关系或合资关系（请用%指出）Page4of16B)PARTICULARSOFHEADQUARTERS(IFANY)总公司概况（如有）1.NameoftheFirm公司全称:2.RegisteredAddress注册地址:3.TelephoneNo.电话:4.FaxNo.传真:5.Web-siteAddress公司网址:6.TypeofCompany经济性质:7.CountryofIncorporation国家:C)FINANCIALCAPACITY财务概况1.NameofBankandAddress银行全称和地址:2.CreditsFacilities/Overdrafts信用设备/透支款项:3.FinancialStandingoftheLast3FinancialYears:过去三年里财务状况Year20__Year20__Year20__AuthorizedCapital注册资金PaidupCapital已缴资金NetWorth净值Page5of16Turnover交易额NetProfit/LossafterTax除税后净利/损CurrentAssets流动资金CurrentLiabilities流动债务NB:ToattachcompleteannualreportswithcorrespondingStatementsofProfitandLossAccountcertifiedbyaccountantsandacertifiedcopyoftheauditedBalanceSheetforthelast3years.请会计员附上过去3年完整的相应年度亏赢报告和审计对比报告。Page6of16D)PARTICULARSOFPARTNERS/PROPRIETOR/DIRECTORSASATDATEOFTHISAPPLICATION合伙人/股东/主席人员名单Name名字Designation职位Qualification资历EmploymentHistory雇佣记录OtherDirectorships其他管理者职位ToindicatewhetheranyoftheabovePartners/Proprietors/DirectorsrelatedtotheDirectors/KeymanagementofTheAscottGroupLimited,orCapitalandLimited,SingaporeTechnologiesPteLtd,TemasekHoldings(Private)Limitedand/oritssubsidiaries/associatedcompanies.请指出上述人员是否认识XXX的高层管理人员或XX置地，XXX公司，XXX控股公司或其他下属公司的人员。Yes/No*(*Pleasedeletewherenotapplicable,andif“Yes”,pleasegivedetailsbelow如果是“是”，请详细指出)Page7of16E)PARTICULARSOFKEYMANAGEMENT/EXECUTIVEASATDATEOFTHISAPPLICATION企业上级主管人员名单Name名字Designation职位Qualification资力YearofExperience工作年限YearofEmployment雇佣年限Toindicateanyoftheabovekeymanagement/ExecutivesrelatedtotheDirectors/KeymanagementofTheAscottGroupLimited,orCapitalandLimited,SingaporeTechnologiesPteLtd,TemasekHoldings(Private)Limited,and/oritssubsidiaries/associatescompanies.Yes/No*(*Pleasedeletewherenotapplicable,andif“Yes”,pleasegivedetailsbelow请删除不适用的内容，如果“是”的话，请列出)Page8of16F)TYPEOFPRODUCT(S)/SERVICE(S)PROVIDEDBYTHEFIRM所生产的产品或所提供的服务1.TypeofProduct(s)/:Service(s)产品/服务性质2.Pleaseindicateifthefirmisengagedinthemanufacturingand/ordistributionoftheproductsprovidedbythefirm请指出公司是否是产品的直接供应商或分销商:(*Pleasedeletewherenotapplicable)Manufacturing供应商:Yes/No*Distribution分销商:Yes/No*3.Type(s)and/orbrand(s)ofproduct(s)manufactured产品性质或品牌:4.Type(s)and/orbrand(s)ofproduct(s)distributed产品分销的性质或品牌:5.LocationofManufacturingPlant/FactoryandAddress供应商所在区域和地址:6.Type(s)andlengthofProductWarrantyProvided产品类型和质量保证期ProductType产品类型(brandwhereapplicable品牌可经营区域)LengthofWarranty保证期(months月)Page9of16NB:Toencloserelevantcompanybrochures请附上相关公司的文件Page10of16G)GLOBALPRESENCE/DISTRIBUTIONNETWORK全球销售或代理网络(pleasetickaccordingly)YesNoSoutheastAsia东南亚City/Location城市/区域Mode*模式1.Singapore新加坡2.Indonesia印尼:3.Malaysia马来西亚:4.Myanmar缅甸:5.Philippines菲律宾:6.Thailand泰国:7.Vietnam越南:NorthAsia亚洲北部8.China中国:9.India印度10.Japan日本:11.Korea韩国:Australasia澳大利亚12.Australia澳大利亚:13.NewZealand新西兰:UnitedKingdom英国14.London伦敦:Europe欧洲15.Belgium比利时:16.France法国:17.Germany德国:18.Spain西班牙:MiddleEast中东19.Dubai迪拜:Others(ifany)其他20.Page11of1621.22.23.*Pleasestatemodeviasubsidiarycompanies,factoryset-ups,distributors,agents,etc.etc.请指出公司的模式，工厂组织，发行人，代理商等等Page12of16H)STAFFSTRENGTH员工组织Local当地Worldwide外来人员1.Total总数:2.Management管理人员:3.Others(pleasestate)其他I)OTHERS其他1.Hasthecompanybeenterminatedfromanawardedcontract(ifyes,pleasegivedetailsbelow):公司是否提前终止过合同（如果有，请指出）2.Hasthecompanybeeninvolvedinanylitigation(ifyes,pleasegivedetailsbelow):公司有被牵涉过任何诉讼方面的事宜？（如果有，请指出）3.Hasthecompanybeenservedwithanywritofsummons(ifyes,pleasegivedetailsbelow):公司是否收到过法院方面的传票（如果有，请指出）Page13of16Page14of16J)PARTICULARSOFCLIENTS/PROJECTS/SERVICESINTHELAST5YEARS过去五年内完成的主要工程项目NameofProperty/Project项目名称NameofClient客户名称ContactPerson联系人TelephoneNo.电话ContractValue合同价值ActualCompletionDate实际完成日期NB:Toenclosecopiesoftestimonialswhereapplicable请附上相关可适用的证明文件Page15of16K)PARTICULARSOFCLIENTS/PROJECTS/SERVICESINPROGRESS目前在设计的主要工程项目NameofProperty/Project项目名称NameofClient客户名称ContactPerson联系人TelephoneNo.电话ContractValue合同价值ContractCompletionDate合同到期日期Page16of16NB:Toenclosecopiesoftestimonialswhereapplicable请附上相关可适用的证明文件L)DECLARATION声明1.Icertifythattheinformationprovidedaboveisaccuratetothebestofmyknowledge.Anyinaccuracyormisrepresentationwillrenderthecompanytobedisqualifiedfromtendering.我保证以上所提供的信息是准确无误的。如有任何不附事实的信息，本公司将承担一切责任。Signature签名:Name名字:Designation职位:Date日期: