SUPPLIERS’ DATABASE REGISTRATION FORM

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TABLE 1: ORGANISATIONAL DETAILS Company Name of Business as registered with the Registrar of Companies Trading As Holding Company Company REGISTRATION number Postal Address Physical Address Contact Person: Telephone No: Cellular No: Fax Number e- mail address VAT REGISTRATION number Average annual turnover Which sector does your company belong to? (Refer to Table:9) Core Business (Refer to Table: 12) TABLE 2: BANKING DETAILS (Attach bank stamped proof/copy of cancelled cheque) Name of Bank: Branch Name: Account Number: Type of Bank Account: TABLE 3: BBBEE RATING DETAILS (Attach a certified BBBEE Certificate or a letter from the accountant/auditors) Water for Growth and Sustainable Development Corporate Services Division supplier DATABASE REGISTRATION form Page 1 of 9 Has your company been rated as per BBBEE by an accredited agency?

table 6: ownership groups bee equity ownership percentage of total shares owned by each of the following groups group (this must add-up to 100% of

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