Vendor Registration Form

DISCLAIMER: Completion of this form, and registration in the database, does not imply that a supplier or contractor is approved by EMC as a supplier, nor does it indicate that a supplier / contractor is included on any tender list for the supply of goods or services for which it has registered.

Upcoming procurement opportunities will be posted on this website, the NOIA Website (www.noianet.com) and BIDS Website (www.bids.ca)

Company Information

Company Name

Type of Business:

Consultant
Distributor
Fabricator
Manufacturer
Services Provider

Country of Incorporation

Year of Incorporation (e.g. 1993)

Contact Information

Contact Person Name

Contact Person Title / Position

Email Address

Phone Number Fax Number

Website Address

Mailing Address

Street Address

City

Country

State / Province -- No Province or State --

Postal / ZIP Code

Registered Address (if different from above)

Check this box if your head office address is different than Mailing address

Street Address

City

Country

State / Province -- No Province or State --

Postal / ZIP Code

Business Information

Total Number of Direct Employees:

Company revenue per year for past three years
(leave as '0' for years before business was operational): $CDN (most recent)
$CDN (two years ago)
$CDN (three years) (Use this format: 800,000)

What is the maximum dollar value of a contract PER YEAR you believe your company is capable of handling? $CDN (Use this format: 800,000)

Does your company have and maintain a documented Quality Assurance / Quality Control (QA / QC) program? YES

Is your company registered under the ISO Quality Management Registration Program? YES

In what year were you registered?

Has a customer ever audited your company's quality program? YES

By whom have you been audited? Customer: Year:
Customer: Year:

Relevant Experience Has your company previously supplied goods or services to ExxonMobil? YES

Please specify what experience you have with ExxonMobil

Project	Product / Service	Year

Please list a few of the other projects you've worked on:

Customer	Project	Product / Service	Year

Additional Information

Please list any additional information you feel is relevant to demonstrate your company's ability to provide Hebron with the products / services you have indicated:

Services Your Company Can Provide

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