SECTION 1 Profile

Supplier name:

(For company, insert registered company name; for individual, please put the last name, and the first name as shown in National ID/Passport)
Alternate name (If the name is required in another language, i.e. Cyrillic,):

Business Relationship:
Spend Authorized (Default)
Prospective Bidder (by exception only)

Tax Organization Type: (Please tick one of the below):

Company/Cooperation UN System
X Individual IGO/IFI/Multilateral/Bilateral organization
Government Entity UNIV/Intl Research Institution
NGO/CSO Others:

Supplier type: (Please tick one of the below):

Supplier Individual (please also select Person type below)

Travel Agency Programme Partner
Person type: (Please tick one of the below):
Staff UN Index ---- Personal Service Agreement
UNV Fellows
Intern Meeting Participants
For others, please specify

Country of Origin (Nationality): National ID:

Tax Country: Tax Registration Number

SECTION 2 CONTACT INFORMATION

Contact 1: User Account

Last Name First Name Middle Name

E-mail Address:
Phone:(Please include the Country Code) Mobile:

Contact 2: Admin Account

Last Name First Name Middle Name

E-mail Address:
Phone:(Please include the Country Code) Mobile:

SECTION 3 ADDRESS
Country Phone

Address Fax

Email
v
Address Purpose (Please tick the relevant box only)

City Ordering

State Remit To

Postal Code RFQ or Bidding

Province

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SECTION 4 BUSINESS CLASSIFICATION

Disabled owner Small Business

ISO Certifications (please provide a copy of the certificate) Other Certifications Please ( please provide a copy)
Minority-owned Women-owned entity (51% or more)
Women-owned entity (51% or more) – self Proclaimed /Not extremally certified – extremally certified
(please provide a copy of the certificate) None of the above

SECTION 5 BENEFICIARY BANK ACCOUNT DETAILS

Bank Account 1
Bank Country:

Bank Name:

Branch Name: Swift Code/ Routing number: Currency:

Account Name: (name as it appears on bank account): Account Number:

IBAN: Account Type:

Bank Code: Branch Code:

Transit Code (5 digits) Canadian Banks: BSB code (6 digits) Australia Banks:

Bank Information for Intermediary/Correspondent Bank ( if applicable)

Name of Bank: Address of Bank:

Branch number: IBAN:

Intermediary Bank Account No: SWIFT Code: FEDWIRE NO. (US BANKS ONLY)

Bank Account 2
Bank Name:

Branch: Swift Code: Currency:

Account Name: (name as it appears on bank account): Account Number:

IBAN: Account Type:

Transit Code ( 5 digits) Canadian Banks: BSB code (6 digits) Australia Banks:

Bank Information for Intermediary/Correspondent Bank ( if applicable)

Name of Bank: Address of Bank:

Branch number: Bank code: IBAN Intermediary Bank:

Intermediary Bank Account No: SWIFT Code: FEDWIRE NO. ( US BANKS ONLY)

SECTION 6 PRODUCTS AND SERVICES

(Please tick the relevant box ONLY)

Raw Materials, Chemicals, Paper, Fuel

Industrial Equipment & Tools
Components & Supplies
Construction, Transportation & Facility Equipment & Supplies
Medical, Laboratory & Test Equipment & Supplies & Pharmaceuticals
Food, Cleaning & Service Industry Equipment & Supplies
Business, Communication & Technology Equipment & Supplies
Défense, Security & Safety Equipment & Supplies
Personal, Domestic & Consumer Equipment & Supplies
Services

SECTION 7 QUESTIONNAIRE

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 1. Please provide copies of one/ both of the below Mandatory Supporting Documents
a. Business Registration Certificate
b. Official document confirming tax registration status and number

2. An electronic funds transfer (EFT) is the default and standard payment method.
Any other payment method(s) in absence of EFT will need to be supported with justification.

The Proof of Banking (POB) should clearly identify the bank name, bank account name (should be same as supplier name),
account number, and other bank credentials such as SWIFT, routing number, and IBAN, where applicable.

Any of the following documents can be accepted:

a) Void cheque
b) Bank reference
c) Screenshot with online banking details without transactions or bank balance
d) Copy of the bank card with the account number
e) Copy of bank statements without details.
a. Electronic fund transfer - please ensure the Bank Accounts section of the supplier profile is completed and
provide Proof of Banking
b. Check payment - please provide justification in the comment box as we encourage all suppliers to be
paid electronically
Comments

I, ____________________________, in my capacity as __________________________, hereby authorise the agency to direct

payments for goods and services to the above account. Signature: ______________________________________