IES-ADM-VRF-0001_rev00

INTERNATIONAL ENERGY SERVICES LIMITED

APPLICATION FOR REGISTRATION AS A VENDOR

A) GENERAL INFORMATION
Type of Registration Limited Liability Business
Name of Company:
(Please tick) Company Name
Website: Telephone: Email Address:

Registered Office Address:

Name: Name: Name:

Principal Owners or Partners

Nigerian Reg. Data: Companies Decree Reg. Number: Date:

B) COMPANY INFORMATION

State Paid Up Capital: State Turnover for the last 12 months:

State Equity Participation of Nigerian Citizens or Associations in your company:
How long have you been in this type of
State Major Type of Service(s) Offered
business/service(s)? …………Years
1. 2. 3.
Directorship (Please states names of Company Directors and their Nationality)
Names (Please print in capital letters) Nationality Names (Please print in capital letters) Nationality

1. 3.

2. 4.

Is there any personnel of IESL associated with this company YES NO (if yes please list below)
Names Relationship Names Relationship
1. 3
2. 4

C) COMPLIANCE

TIN No: VAT No: DPR No:

List of Insurances obtained & Policy Value
Names Insurance Company (Please
Type of Policy Value Of Policy Policy No:
print in capital letters)
1.
2.

3.

D) WORK PERFORMANCE HISTORY (Please provide details of similar service(s) performed in the past for reputable clients)
Execution Total Value of
Client Location Client contact person
Date Contract
1.
2.
3.
4.

Banking Details (Please provide details of your company bank accounts)

Account Account
Bank Name Location Remarks
Type Number
1.
 IES-ADM-VRF-0001_rev00

2.
 IES-ADM-VRF-0001_rev00

Prepared By: Date:

I hereby apply for registration as a vendor with International Energy Services Limited (IESL) and confirm that the information
provided is correct and I undertake to notify IESL of any changes or alterations to the above information.

I understand and accept that registration does not amount to a guarantee that my organisation will be invited to tender or will be
awarded a contract with IESL.

NAME: POSITION:

APPLICANT’S SIGN/DATE: STAMP

APPENDIX “ A”
REGISTRATION AND ENQUIRIES

Registration Requirements

1. A copy of your Certificate of Incorporation/Registration.

2. A copy CTC of Form CAC 2 & 7 or Business Name Registration Form
3. A copy of your VAT Certificate of Registration.
4. A copy of current Tax Clearance Certificate from the Federal Government of Nigeria.
5. Two (2) reference letters from clients listed in Section D

Letter of Guarantee

Submission of Registration Documents

 IESL shall not process incomplete set of documents.

 Completed forms and registration documents shall be sent online to vendor.registration@ieslglobal.com

 Please note that registration is not a guarantee of patronage or award of contracts by IESL.