Supplier registration

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1 Step 1
SUPPLIER REGISTRATION FORM
1. Company Details
a. Name of applicant
b. Trading name of Applicant
c. Physical Address
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d. Postal Address
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e. Telephone No.
f. Fax
h. Website Address
i. Tax Registration Number
j. VAT Number (if applicable)
k. PPADB Code
l.EDD certificate No.
l.EDD certificate No.
2. Contact Person Information
a. Name of Contact Person
C. Telephone No.
3. Services and portfolio
a. Provide Details of Servicesa. What does the company do
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b. The supplier is requested to indicate/ mark their area of goods and servicesSUPPLIER CATEGORY OF GOODS AND SERVICES (same as ppadb)
Service name/descriptionPPADB CodePPADB Sub Code
×
×
(2)
4. Shareholder Details
a. Please provide details of the shareholders of the Applicant (if the Applicant is a company):(complete and upload the attached Declaration Form for Tendering Purposes, appendix A)
Name of ShareholderCitizenship% of shares heldTelephone No.Email
×
×
(2)
b. Please provide details of the directors of the Applicant (if the Applicant is a company):
Name Of DirectorCitizenship% of sharesId No. or Passport No.Telephone No.Email
×
×
(2)
5. Employee Participation

a. Please provide the details of the employment levels of the operation:

No. of citizen employees:
No. of non-citizen employees:
b Please provide the job classification of employees noted in (a) above:
Job ClassificationCitizensNon-Citizens
×
×
(2)
6. Types of Benefit- COMPANY OWNERSHIP OR CONTROLLED
a. (Indicate the status of the company by ticking the appropriate box hereunder that the above mentioned business is 100% owned by women/ youth/ people with disability(attach certified copy of ID & complete the Local Procurement Registration Certificate- APPENDIX B)
7. Past experience reference
a. Please provide names and contact details of references(please attach atleast on reference in the upload center)
Company NameProject titleContact NameTelephone No.Email
×
×
(2)
8. DECLARATION OF INTEREST
a. Does any employee or board member of the Gambling Authority have any interest, financial or otherwise in the applicant companypick one!
b. if you answered yes above please Indicate the relationship/association between your company and any of the employee (s) of the Botswana Gambling Authority
Employee NameRelationship/association
×
×
(2)

DOCUMENTS TO BE SUBMITTED WITH THIS APPLICATION

1. Certified copy of certificate of incorporation or certificate of registration (if the Applicant is a company);
Upload
2. Certified copies of share certificates (if the Applicant is a company);
Upload
3. Proof of ownership/directorship (certified copies of ID or passport)
Upload
4. Certified copy of tax clearance certificate of the Applicant (if applicable)
Upload
5. Certified copy of EDD certificate (if applicable)
Upload
6. Company Profile
Upload
7. portfolio of previous work
Upload
8. Local procurement registration certificate (if applicable)
Upload
9. Signed statement of declaration
Upload
I certify that the information supplied on this application form (please print name clearly) is true and correct. I understand that failure to provide true and correct information will result in the failure of this application.
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