Vendor Criteria Requirement for

Local company - tax registered

Local company - Non tax

registered

Overseas company
 Vendor Registration
Vendor Registration Form
TDP
SPPKP + NPWP
SIUP/IUP
SIUJK ( contractor )
Domisili
FCPA
Authorised letter
Akta
Bank account statement
Bukti Setoran Pajak last 3months
Surat Pemberitahuan Nomor Faktur Pajak
Signature Specimen on Tax Invoice
Sign term and conditions
Vendor Registration Form
Statement Letter for Non -Tax registered company
Statement Letter for Personal Bank account
NPWP
Personal ID
Sign term and conditions

Vendor Registration Form

COO or Company Business Registration
Authorised letter
Sign term and conditions
FCPA
 Necessity
Must
Must
Must
Must
Must
Must
Must SURAT PERNYATAAN
Must if AD for certain brands FCPA
REKENING BANK
Must for signed agreement of both parties
Must
Must
Must T&C
Must
Must
Must
Must
Must SURAT PERNYATAAN
Must NON-PKP
Must
Must

Must
Must
Must if AD for certain brands
Must
Must
 Payment
Invoice
Tax Invoice (VAT)
Delivery Order / Packing List
Acceptance Letter/Berita Acara ( Service )
Copy PO / Contract agreement

T PERNYATAAN
FCPA
ENING BANK
Document

T&C

SURAT PERNYATAAN
NON-PKP

DGT form ( will be required for service . If not, we need to paid tax )
Packing List
Bill of Lading / Air Way Bill
Invoice
Copy PO / Contract agreement
 Remarks

Not later than 3 months after DO date

signed by WH + company Stamp

1original
1original , 2 copy original
1original , 2 copy original
1original , 2 copy original
1copy
 CARGILL STRATEGIC SOURCING AND PROCUREME
SUPPLIER PROFILE FORM
1 Name of the Vendor (*)
2 Address (*)
Street
City
District
Postal No
Country (*)
Telephone (*)
Fax (*)
E-mail address (*)
Website
Business Language (*)
Business currency (*)
3 Other Details
Total annual turnover ($):
for last 3 years (pls enclose balance sheet)
Year of commencement
Nature of business (*)
Pattern of business holding (*)
Name of the parent company
Name of the principal company
Have you ever been business with Cargill Indonesia
(if yes-detail year of interaction and purpose)
Lead time (days)
Production capacity (per month)
Term payment

4 Vendor's Banker (*)

Currency (*)
Bank Name (*)
Address (*)
A/C Name (*)
A/C No (*)
Swift Code
5 NPWP No (Tax account No)
NPWP Name (Tax account name)

6 List your top five customers in order of business volume

Name, location of the customer, project details
a
b
c
d
e
7 Details of product / services offered (Pls enclose the product catalogues)

8 Organisation structure of your company (pls enclose a copy)

Number of employees

9 Name of key persons in yours organisation (*)

10 Sales Contact Person (*):

Name (*)
Position (*)
Telp (*)
Fax (*)
Handphone
E-mail address (*)

11 Finance Contact Person (*):

Name (*)
Position (*)
Telp (*)
Fax (*)
Handphone
E-mail address (*)

12 Quality system Accreditation (ISO 9000, TUV, etc) (if yes, pls enclose details)
Quality system
Agency
Year Received

13 Inspection & Testing facilities and procedures for the product and service offered (pls enclose details)

14 Details of your associates/ authorised dealers/ service centers to deal with Cargill Group

15 Business with Cargill Group

Are you supplying to any other Cargill Group Companies
 (If yes, pls include which unti and items supplied)
Unit

16 Relationship with any Cargill Group Employee/ Ex-Employee (Please give details of the person and relati

17 Please provide the following details:

Product catalogues; Company Profile; Quality policies and certification;Organizatioanl charts

18 Declarations
We hereby certify that the above particulars are true and correct and accept that Cargill Group has the
details given as part of this submission

Name : Tri Eko S

Position : Credit Officer
Date : 14 March 2019

(*) : mandatory fields

ND PROCUREMENT INDONESIA
FILE FORM
Singgasana Hotel Surabaya
JL.Gunung Sari Surabaya

Surabaya
031-568 2703
031-568 2081
info@surabaya.singgasanahotels.com
www.surabaya.singgasanahotels.com

Year 1
Year 2
Year 3

Manufacturer/ Authorised Dealer/ Trader

Properietorship/ Partneship/ Public Ltd (please attach copy of
registration)

Singgasana Hotel Surabaya

IDR
Bank Mandiri Cab.Mayjen Sungkono
JL.Mayjen Sungkono ,Surabaya
PT.Patra Indonesia
141 000 62 77776
BMRI IDJA

Annual business.$ % of your total business

 Mgmt Skilled Unskilled Total

Positions
Director
Finance Manager
Sales Manager
Logistic Manager

Yeni Fitri Handayani

Sales Manager
031-568 2703/ Ext.7909
031-568 2081

sales-2@surabaya.singgasanahotels.com

Tri Eko Sasongko

Credit Officer
031-568 2703/ Ext.7932

credit@surabaya.singgasanahotels.com

(pls enclose details)

l Group
 Item supplied

of the person and relationship)

Cargill Group has the right to verify as and when required all documents and

Signatory Company seal