Agro Prestasi Vendor Registration

Section A: Company Information

Company Name

Company Registration No

Date of Incorporation

Phone

Fax

Email

Website

Company Address

Section B: Company Representatives

Name

Position

Contact Number

Email

Shareholders / Directors

Section C: Business Nature

Manufacturing Service Trading Other

Main Products / Services Offered

Relevant Industry Experience

Annual Revenue (latest audited)

Number of Employees

Section D: Banking Details

Bank Name

Bank Account Name

Bank Account Number

Bank Address

Bank Officer Name

Bank Officer Contact

Section E: Certifications & Licenses

Please tick and attach the following certificates (if applicable):

SSM Certificate / Section 17 Business License (SSM / DBKK) HALAL Certification HACCP / ISO / GACC / CIQ MOF Certificate / Bumiputera Status DVS / MAQIS / Import-Export Permit

Section F: Declarations

Conflict of Interest Declaration – any relation with APSB officers?

Yes No

Anti-Bribery and Corruption Policy Statement Attached?

Yes No

Acknowledgement of PDPA 2010 Compliance

Yes No

Safety & Health Compliance (for site vendors)

Yes No

Please compile all related certification/license documentation into a single PDF file and upload it here:

I hereby declare that all information provided is true and complete, and I agree to comply with all procurement policies of Agro Prestasi Sdn. Bhd. Yes, I Agree

APBS Vendor Registration Form

Section A: Company Information

Section B: Company Representatives

Shareholders / Directors

Section C: Business Nature

Section D: Banking Details

Section E: Certifications & Licenses

Section F: Declarations