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REGISTRATION FORM
From: (Name & Full address of the firm): …………….…………………………………………………..
………………………………………………………………
To
The Stores Purchase Officer
Doon University,
Dehradun- 248001
Dear Sir,
We are to request you kindly to register our name as an approved supplier for the following categories:
1. …………………………………………………………………………….
2. …………………………………………………………………………….
3. …………………………………………………………………………….
Necessary particulars regarding our credential are given below:
1. Full name & address of the firm ………………………………………….
2. Telephone & Fax No. ………………………………………….
3. E-mail I.D. ………………………………………….
4. Status (whether manufacturer/sole distributors/ ………………………………………….
authorized agent of stockiest of the item) ………………………………………….
(send a copy of competent authority) ………………………………………….
5. Value of stock generally held at a time ………………………………………….
6. Size and location of stores ………………………………………….
7. Reference alongwith value of the order placed by ………………………………………….
other Govt./Semi Govt. deptt. ………………………………………….
8. Sales tax no. (send a copy) ………………………………………….
9. Income tax no. (send a copy) ………………………………………….
10. Please indicate if you are associated with any other ………………………………………….
concern if so the name of the concerned firm may ………………………………………….
be mentioned.
11. Please state if you are on rate contract with ……………………………….................
Uttarakhand/Govt./DGS&D/other Govt. if so send ………………………………………….
a copy of the notification
12. Please certify that (affidavit on Ten Stamp paper) ………………………………………….
you have not been black listed by any department of ………………………………………….
Central/State Govt./Doon University. ………………………………………….
13. Proprietary pattern –
Public Ltd., Co./Private Ltd., Registered Partnership/
sole trade cooperative Concern/ State Undertaking/
Govt. Deptt. Undertaking.
5000/ (Non-refundable) as registration fee in the form of Bank Draft of …………………… vide No……………… dated ……………… payable at Dehradun drawn in favour of Doon University is enclosed here with.
We certify that all the information given above is correct and we will responsible for all damages caused to University. The necessary certificate of the manufacturer certifying as to this firm being the sole distributor/manufacture is enclosed herewith in original.
Yours faithfully,
Encl: As above.
Registered at Sl. No…………………. Category ………………………………………………………..
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