LANCO INDUSTRIES LIMITED

Regd office & works : Rachagunneri (V) – 517641

Srikalahasthi (M), Chittoor (Dist), A.P. India
Ph: 08578-287650-55, 287668 to 70,71,73 Fax: 08578 – 287657,688

VENDOR REGISTRATION FORM

1. Code No. (Please do not fill, only for official use):

2. Name : Prism Castings

3. Firm Type : Partnership

(Private / Public sector etc.)

4. Addresses :

4.1 Dealing Office : SF. No.482, Near Kumar Polycott Mills

Idigarai Main Road, Idigarai

City : Coimbatore
Pin : 641035
Phone No. : 0422 - 2460710
Fax No. :
Email ID : prismcastings@gmail.com
Contact Person Name / Designation : S.SURAJ / General Manager

4.2 Registered Office / Head Office : As above

City :
Pin :
Phone No. :
Fax No. :
Email ID :
Contact Person Name / Designation :

4.3 Other Office(s) : NIL

City :
Pin :
Phone No. :
Fax No. :
Email ID :
Contact Person Name / Designation :

5. Year of Establishment : June 1998

6. Banker’s Name : State Bank of Travancore, SME Branch, TVM,

Kerala

7. Sales Tax Registration No.

State/ TIN No. : 33612026571/ 03.09.07
Central : 901566/ 03.09.07
PAN NO. : AAJFP8023F

8. Excise Registration Details

ECC Code No. : AAJFP8023FXM001

Range : IIE

Division : IIE

PUR-06/Rev.01 Page 1 of 2
 VENDOR REGISTRATION FORM

9. Product Guarantee Period : NIL

10. If you are Agent of any Company / : NIL

Product, give details

11. Are you registered with SSI, : Yes

if Yes, Please indicate Regn. No. & Date
Regn. No. 330121209695. Date: 20.01.2009

12. In case any BIS standard is applicable to the product, please furnish details: NIL

13. Any special / additional information : ISO 9001:2008 CERTIFIED

Signature :
Place : Coimbatore Name : P. Arunkumar
Date : December 7, 2009 Designation : Marketing representative

Seal

Please enclose the following:-

a. List of products/services with supporting catalogue / leaflets.
b. List major customers with whom you are registered.
c. Latest income tax clearance certificate.
d. Annual Profit & Loss account / Balance sheet for last three years.
e. List of equipments and testing facilities (for sub-contractors only).
f. Provide ISO 9001 / BIS certificate if you are certified.

For Our Office Use Only :

1. Required to visit the vendor premises : ( Yes / No )
2. Registered for the following groups :
3. Vendor Code Allotted :
4. Remarks

Date : Signature of Authorised Signatory

PUR-06/Rev.01 Page 2 of 2