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SECTION I:GENERAL INFORMATION
COMPANY REGISTERED NAME
COMPANY PARENT NAME
COUNTRY OF ESTABLISHMENT	QATAR GCC OTHERS(pls.specify)
LEGAL CLASSIFICATION	INDIVIDUAL OWNED PARTNERSHIP JOINT VENTURE LIMITED LIABILITY COMPANY OTHERS(pls.specify)
REGISTERED BUSINESS ADDRESS	BLDG.NAME	BLDG.NO	FLOOR NO.
	STREET NAME	STREET.NO	ZONE NO.
	CITY	COUNTRY	POSTAL CODE
PO BOX NO.		TELEPHONE NUMBER
EMAIL ADDRESS		FAX NUMBER
NATURE OF BUSINESS	TRADER MANUFACTURER CONTRACTOR DISTRIBUTOR CONSULTANT SERVICE PROVIDER OTHERS(please specify)
FIELD OF TRADE	PRODUCTS(please specify)
	SERVICES(please specify)
	WORKS(please specify)
NAME OF CONTACT PERSON		JOB TITLE
EMAIL ADDRESS		MOBILE NO
TELEPHONE NO:		FAX NO
UPLOAD DOCUMENTS: The documents must be a file of type: jpeg, pdf, doc, docx
Company Registration(CR)	Trade Licence	Company Signature	Others Documents 1(optional)
Others Documents 2(optional)	Others Documents 3(optional)	Others Documents 4(optional)	Others Documents 5(optional)
Please specify the name of documents attached with

SECTION III.B : WITHHOLDING TAX DETAILS
NATURE OF THE OFFICE		LOCATION OF OFFICE/S
PERMANENT TYPE TEMPORARY OFFICE		LOCAL OFFICE(QATAR) FOREIGN OFFICE
COMMERCIAL REGISTRATION NO.	QATAR CHAMBER OF COMMERCE MEMBERSHIP		TAX CARD NUMBER
VALIDITY	VALIDITY
OTHER DETAILS

THE REGISTERED SUPPLIERS ARE REQUIRED TO IMMEDIATELY INFORM ALAQARIA PROCUREMENT DEPARTMENT OF ANY SIGNIFICANT CHANGE TO THEIR:
FINANCIAL CAPACITY OR TECHNICAL CAPABILITY OWNERSHIP OR HOLDING ANY COURT CONVICTIONS OR PROHIBITION ORDERS FROM GOVERMENT AUTHORITIES SIGNIFICANT CHANGES TO SUPPLIER OR SOURCES OF PRODUCTS/SERVICES SIGNIFICANT CHANGES OF RANGE OF PRODUCTS/SERVICES OFFERED	CHANGES IN ADDRESS,PHONE,EMAIL,FAX,CONTACT PERSON OR COMMUNICATION DETAILS. ALAQARIA MAY MAKE REVISIONS TO THE REGISTRATION SCHEME,OR SEEK NEW APPLICATIONS AT ANY TIME.WHENEVER A FULL REVISION OF THE SYSTEM IS CARRIED OUT,ADDITIONAL INFORMATION OR NEW APPLICATIONS FROM CURRENT PRE-QUALIFIED SUPPLIERS WILL BE SOUGHT
ALAQARIA PROCUREMENT DEPARTMENT	EMAIL:procurementdept@alaqaria.com.qa	TEL:44086041/44086047/44086052

DECLARATION

SECTION II:EXPERIENCES & CERTIFICATIONS
NO.OF YEARS IN CURRENT BUSINESS	LESS THAN A YEAR	1-5	6-10	11-15	16-20	>21(Please Specify)
THREE MAJOR CLIENTS FOR THE PAST 3 YEARS	CLIENT		LOCATION		DURATION
	CLIENT		LOCATION		DURATION
	CLIENT		LOCATION		DURATION
HAVE YOU HAD ANY CONTRACTS TERMINATED DUE TO POOR PERFORMANCE IN THE LAST 3 YEARS ?					YES	NO
IF YES PLEASE SPECIFY
PREVIOUS BUSINESS NAME(IF RECENTLY CHANGED)			PLS.SPECIFY REASON FOR CHANGE
CERTIFICATIONS	ISO 9001	ISO 14001	OHSAS 18001	OTHERS(PLS Specify)
CERTIFICATION BODY				VALIDITY
CERTIFICATION BODY				VALIDITY