Vendor Registration Form

Section 1: Company Details and General Information

Name of Company *

Enter the name of your company wishing to register as Ecomak’s partner.

Type of Business *

Proprietorship
Private Limited
Partnership
Other

Required for accounting and compliance reasons.

Contact Person *

Telephone *

Enter your 10 digit phone number, along with the ISD code. (Eg: +91-XXXXX-XXXXX)

Phone *

Enter your 10 digit mobile phone number, along with the ISD code. (Eg: +91-XXXXX-XXXXX)

Email *

Confirm Email

All important communication from Ecomak will be sent to this address.

Office Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Website / URL

Enter your company website URL.

Year Established *

What year was your company incorporated?

Is your factory/works location located is the same as the office address?

Works Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Enter the address of your factory/workshop/works unit.

Parent Company (Full Legal Name) *

State in which the company is registered *

Registration Number (CIN) *

Section 2: Financial Details

Ecomak Systems endeavours to safeguard and ensure the security of the information provided by its partners. For additional information: https://ecomak.co.in/privacy-policy/

GST Number *

Sales Tax Number *

PAN Number *

Bank Name *

Address/Branch *

Swift/BIC *

Bank Account Number *

Account Name *

Cancelled Cheque *

Click or drag a file to this area to upload.

Allowed extensions – PDF, JPEG, JPG

Undertaking *

By checking this box I agree to receive funds online along with associated and transaction charges

Section 3: Technical Capability and Information on Goods/Services Offered

Project/Product or Services Offered *

Quality Assurance certification (e.g.: ISO 9000 or Equivalent) (Attach a latest copy)

Click or drag a file to this area to upload.

List any National or International Trade or Professional Organizations of which your Company is a Member.

International Offices/Representation (Countries where the Company has local Offices/Representation) {Country, City}

List below up to ten(10) of your core Goods/Services Offered

Total number of employees/workers

List of tools and calibration status

Certification *

I Agree

I, the undersigned, hereby accept the basic General Conditions – a copy of which has been provided to me and warrant that the information provided in this form is correct. In the event of change, details will be provided as soon as possible.

Name *

Functional Title *

Note:

This form is subject to change as desired by the administration without any prior notice.
Please allow 2-3 business days for a response after submission.

Vendor Registration Form