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[{"$nulls":4},"CONTRACTOR/SUPPLIER REGISTRATION FORM",{"$nulls":13},"Form",null,":  CPD/R/1"]
[{"$nulls":18},"Revision",null,":  4"]
[{"$nulls":18},"Effective Date",null,":  OCT 2010"]
[]
[{"$nulls":3},"Firm / Company Name           ",{"$nulls":4},":"]
[]
[null,"CHECKLIST"]
[null,null,"Documents To Be Attached",{"$nulls":3},"Note: ","•  Applicants shall perform their own checks of information submitted. Please tick boxes for documents attached."]
[{"$nulls":7},"•  Please mark ( X ) where applicable."]
[{"$nulls":7},"• * Certified by Suruhanjaya Syarikat Malaysia / Advocate / Solicitor / Company Secretary."]
[null,"(A)","Limited (Sdn Bhd) or Public Listed Company"]
[null,null,"(1)",null,"Form 13 *",{"$nulls":4},"Certificate of Incorporation on change of name of company"]
[]
[null,null,"(2)",null,"Form 24 *",{"$nulls":4},"Return of Allotment of Shares"]
[]
[null,null,"(3)",null,"Form 32A *",{"$nulls":4},"Form of Transfer of Shares (where applicable)"]
[]
[null,null,"(4)",null,"Form 49 *",{"$nulls":4},"Return giving particulars in register of directors, managers, and secretaries and changes of particulars"]
[]
[null,null,"(5)",null,"Form of Annual Return *",{"$nulls":4},"Form of Annual Return of a Company Having a Share Capital"]
[]
[null,null,"(6)",null,"Certified Auditor's Report *",{"$nulls":4},"Contractors to attach past three (3) years' audited reports.  Suppliers to attach past one (1) year's audited report"]
[]
[null,null,"Firm (i.e. Sole Proprietorship or Partnership)"]
[null,null,"(7)",null,"Business Name Registration",{"$nulls":4},"Extract of Registration of Business Name (Pengesahan Pendaftaran Nama Perniagaan)"]
[]
[null,null,"(8)",null,"Change Of Proprietorship Or Partnership",{"$nulls":4},"Document evidencing change of proprietorship or partnership (where applicable)"]
[null,"(B)","Other Supporting Documents "]
[null,null,"(9)",null,"Form 8 / Form 9",{"$nulls":4},"Certificate of Incorporation of Public Company, Certificate of Incorporation of Private Company, Certificate of Registration (Sijil Pendaftaran) (whichever is applicable)"]
[]
[null,null,"(10)",null,"Form I",{"$nulls":4},"Valid Trade Licence"]
[]
[null,null,"(11)",null,"Company Profile",{"$nulls":4},"Company profile "]
[]
[null,null,"(12)",null,"Registration Certificate *",{"$nulls":4},"e.g. UPK, PKK, CIDB, Petronas, SESCO, etc. (Where applicable)"]
[]
[null,null,"(13)",null,"Financial Information",{"$nulls":4},"Past three (3) months' bank statements, copies of fixed deposit accounts' statements, savings accounts' statements, certified copy of secured overdraft facilities, and amount of balance of overdraft facilities not utilised"]
[]
[null,null,"(14)",null,"Plant And Machinery ",{"$nulls":4},"Number of plant and machinery owned or leased (where applicable)"]
[]
[null,null,"(15)",null,"Quality System",{"$nulls":4},"Quality System Certificate(s) (Where applicable)"]
[]
[null,null,"(16)",null,"Past Experience / Products supply (MANDATORY) ",{"$nulls":4},"Past projects performed / list of products supplied, etc."]
[]
[]
[]
[null,"Name of Firm / Company",{"$nulls":5},":",0]
[]
[null,"Business / Company Registration No",{"$nulls":5},":",{"$nulls":6},"Establishment Details :",null,null,"Date"]
[]
[{"$nulls":17},"Place"]
[null,"Please mark ( X ) where applicable:"]
[null,"Type Of Application",{"$nulls":5},":",null,"New Application"]
[]
[{"$nulls":9},"Renewal Of Registration / Upgrading",{"$nulls":6},"Please tick if there has been a change of address since your last registration."]
[]
[]
[]
[null,1,"COMPANY INFORMATION"]
[]
[null,null,"(a)","Registration Address"]
[]
[]
[]
[null,null,"(b)","Correspondence Address"]
[]
[]
[]
[null,null,"(c)","Name Of Person Responsible For Application"]
[]
[null,null,"(d)","Contact No. *"]
[]
[null,null,"(e)","Fax No. *"]
[]
[null,null,"(f)","E-mail Address "]
[null,null,"* Note:  Application without Telephone Number and/or Fax Number shall be rejected."]
[null,null,"Future new Address & Contact No. (if any)"]
[null,null,"effective date :                                         "]
[]
[]
[]
[null,2,"CATEGORIES APPLIED"]
[]
[null,2.1,"For Contractor Registration (Please mark ( X ) where applicable)",{"$nulls":9},2.2,"For Supplier Registration (Please mark ( X ) where applicable)"]
[null,null,"2.1.1 ","Grade / Class Applied ",{"$nulls":9},"2.2.1","Grade / Class Applied "]
[]
[{"$nulls":3},"Grade","Your Tendering Capacity (RM)",{"$nulls":9},"Class","Your Paid Up Capital (RM)"]
[]
[{"$nulls":3},"G1","Not exceeding 100,000.00",{"$nulls":9},"A",{"v":200001,"d":"200,001"}]
[]
[{"$nulls":3},"G2","Not exceeding 500,000.00",{"$nulls":9},"B",{"v":50001,"d":"50,001"}]
[]
[{"$nulls":3},"G3","Not exceeding 1 million",{"$nulls":9},"C",{"v":5001,"d":"5,001"}]
[]
[{"$nulls":3},"G4","Not exceeding 3 million",{"$nulls":8},"2.2.2","Category for Supplies & Services"]
[]
[{"$nulls":3},"G5","Not exceeding 5 million",{"$nulls":9},"I","Civil Engineering and Building Materials"]
[]
[{"$nulls":3},"G6","Not exceeding 10 million",{"$nulls":9},"II","Mechanical and Electrical Engineering Plants/Equipment"]
[]
[{"$nulls":3},"G7","No limit",{"$nulls":9},"III","Water Supply Materials"]
[]
[null,null,"2.1.2","Category of Work / Supplies and Services Applied ",{"$nulls":10},"IV","Office Machines/Equipment/Technical Supplies And Others"]
[]
[{"$nulls":3},"CE","Civil Engineering Construction ",{"$nulls":9},"V","Chemicals And Materials"]
[]
[{"$nulls":3},"B","Building Construction",{"$nulls":9},"VI","General Supplies"]
[]
[{"$nulls":3},"ME","Mechanical and Electrical",{"$nulls":9},"VII","Charter Services"]
[]
[{"$nulls":14},"VIII","Books/Printing"]
[]
[{"$nulls":14},"IX","Miscellaneous"]
[]
[null,null,"Work Specialization  (for specialization code details, please refer to relevant CATEGORY from page A2 to A7 of Appendix A, Contrator Registration)",{"$nulls":10},"Sub-Head and Items Detail  (for Sub-Head and items detail, please refer to relevant HEAD from page A9 to A24 of Appendix A, Supplier Registration)"]
[]
[]
[]
[null,null,"e.g. B01",{"$nulls":10},"e.g. IX 1(A), 1(B)"]
{"$rows_empty":12}
[null,3,"PROJECTS / SERVICES / DEALERSHIP / AGENCIES"]
[]
[null,3.1,"Current and Past Three (3) Years Projects from Date of Registration "]
[null,null,"• Where applicable, attach copies of documents evidencing that you are undertaking the project and / or are duly authorized by the principal (Letter of Acceptance / Purchase Orders)"]
[null,null,"• Attachment for projects listing is available in Excel spreadsheet format downloadable from CMSB website: http://www.cmsb.com.my/doing/index.htm"]
[]
[null,"Item","Name of Project / Product ",{"$nulls":3},"Employer /\nManufacturer / Consultant / Reference",null,null,"Major Scope",null,null,"Contract Value\n(RM)",null,"Dealership / Agency / Project Start Date",null,null,"Dealership / Agency Expiry date OR Project Completion Date",null,null,"Grade / Class","Category","Specialization"]
{"$rows_empty":26}
[null,4,"FINANCIAL RESOURCES"]
[null,4.1,"For Private Company / Public Company"]
[]
[null,null,"Share Capital: "]
[null,null,"Authorised Capital:",null,null,"RM",{"$nulls":9},"Paid-Up Capital:",null,"RM"]
[]
[null,4.2,"For Sole Proprietorship / Partnership Firm "]
[]
[null,null,"Net Capital Worth:",{"$nulls":14},"(RM)"]
[null,null,"(a)","Average of Total from latest three (3) months' bank account statement:",{"$nulls":3},"RM",null,null,"(Month:",{"$nulls":3},")"]
[]
[{"$nulls":7},"RM",null,null,"(Month:",{"$nulls":3},")"]
[]
[{"$nulls":7},"RM",null,null,"(Month:",{"$nulls":3},")"]
[]
[{"$nulls":5},"Total :",null,"RM",0,{"$nulls":8},"(a)",0]
[]
[]
[null,null,"(b)","Overdraft Facilities",{"$nulls":3},"RM",null,null,"(Bank:",{"$nulls":5},")"]
[]
[{"$nulls":7},"RM",null,null,"(Bank:",{"$nulls":5},")"]
[]
[{"$nulls":7},"RM",null,null,"(Bank:",{"$nulls":5},")","(b)"]
[]
[null,null,"(c)","Fixed deposit(s) and Savings account(s) (including those of sole proprietors / partners) which is / are not charged to any bank or financial institution",{"$nulls":13},"(c)"]
[]
[null,null,"(d)","Savings account",{"$nulls":13},"(d)"]
[]
[null,null,"(e)","TOTAL",{"$nulls":13},"(e)",0]
[null,"*","Reminder: Please attach bank statements / documents issued from banks for the above items."]
[]
[null,5,"QUALITY MANAGEMENT SYSTEMS "]
[]
[{"$nulls":4},"Yes   (please specify and attach certificate)",{"$nulls":12},"No"]
[]
[{"$nulls":3},"Type   (e.g. ISO 9001, ISO 14001, OHSAS 18001)",{"$nulls":8},"Certification Body",{"$nulls":5},"Expiry"]
[]
[null,null,"(a)"]
[]
[null,null,"(b)"]
[]
[]
[]
[null,6,"COMPANY PROFILE"]
[]
[null,null,"Please attach a copy of your company's profile (if available)."]
[]
[{"$nulls":4},"Yes   ",{"$nulls":12},"No"]
[]
[]
[null,7,"DECLARATION"]
[]
[null,7.1,"The applicant hereby declares and confirms that the information given and copies of documents submitted with this application areup to date and correct.The applicant is aware and understands that any information or documents submitted which is/are false or untrue shall cause the application to be rejected and any approval given shall be revoked."]
[]
[]
[null,7.2,"The applicant agrees that in the event my application for Registration is successful, the applicant shall comply with the \"Terms And Conditions Of Registration\" (Copy of which is annexed as Appendix D) and \"Code Of Ethics And Business Conduct For Contractors And Suppliers) (a copy of which is annexed as Appendix E)."]
[]
[]
[null,7.3,"The applicant hereby authorizes CMSB to request any information on him from any financial institution(s) and/or any other bodies, agencies or organisations which have any dealings with him at any time."]
[]
[]
[]
[]
[]
[null,"Authorized Signature"]
[{"$nulls":4},":",{"$nulls":9},"Date",null,null,":"]
[]
[null,"Name",null,null,":"]
[]
[null,"I.C. No.",null,null,":"]
[]
[null,"Designation",null,null,":"]
[{"$nulls":14},"Firm / Company Stamp"]
[null,"For and \non behalf of",null,null,":",0,{"$nulls":11},":"]