CO-PD-F04A

3rd Floor Solmac Building, Banaue cor. Dapitan Streets, Quezon City, Philippines
x Regular Supplier 732-4185 • 741-3307• 732-5361 - Fax 712-0677 SUPPLIER CODE
One-time Vendor

SUPPLIER ACCREDITATION APPLICATION FORM - A

Note: All items marked with askterisk ( * ) are required. Please do not leave any item blank. Write N/A if information requested is not applicable to your
company.
I. SUPPLIER INFORMATION SUPPLIER CATEGORY

BUSINESS NAME * : FJD TRANSPORT SERVICES Local Manufacturer Foreign Manufacturer

REGISTERED ADDRESS * : 350 TRES DE ABRIL ST., CEBU CITY Local Distributor Foreign Distributor
transport
DATE ORGANIZED : 10-Aug-17 Dealer x Others: provider
TELEPHONE NO. * : 9178804691 FAX NO. * :

WEBSITE ADDRESS : NA EMAIL ADDRESS * : fjdtransport25@gmail.com

QUIJANO COMPOUND, V. RAMA AVENUE, CEBU
SATELLITE OFFICE : NA WAREHOUSE ADDRESS : CITY
CONTACT PERSON* : FRITZ VERNIE A. LAPASTORA POSITION * : PROPRIETOR

PRODUCT LINE (please attach certificate of exclusibility if there are any)

MAJOR : TRANSPORT SERVICES

OTHERS :

TYPE OF BUSINESS * :
x SINGLE PROPRIETOR NATURE OF BUSINESS * : MANUFACTURING
PARTNERSHIP x SERVICE
CORPORATION MERCHANDISING
DTI/SEC. REG. NO. : 4080296 DTI/SEC. REG. DATE : 10-Aug-17
TIN * : 706-573-019 TIN REG. DATE : 11-Aug-17
VAT NO. * : Non-Vat VAT REG. DATE :

VAT-ABLE * : YES x NO TERMS OF PAYMENT * :

EWT % * :

II. COMPANY OWNER / OFFICERS

NAME POSITION ADDRESS TEL. NO. TIN

FRITZ VERNIE A. LAPASTORA OWNER* QUIJANO COMPOUND, V. RAMA AVE., CEBU

9178048568
CITY 706-573-019

III. AFFILIATED COMPANIES & RELATED BUSINESS

COMPANY NAME % OF OWNERSHIP ADDRESS & CONTACT NO.

NONE

IV. MAJOR CLIENTS

COMPANY NAME ADDRESS CONTACT PERSON / CONTACT NO.

GOVERNMENT VARIOUS GOVERNMENT AGENCIES

BP WATERWORKS CEBU CITY

AERO-KNOTICAL POWER CORP. CEBU CITY

TERP-ASIA CORPORATION CEBU CITY

 CO-PD-F04A

Note: Please do not leave any item blank. Write N/A if information requested is not applicable to your company.
VI. QUALITY & ENVIRONMENTAL MANAGEMENT
Do you have a documented Quality Management System (QMS)? Yes x No
Type
If yes, please submit a copy of the certificate.
If no, do you operate your own internal QMS? x Yes No
If yes, please supply a copy of your in-house quality procedures/systems.
Do you have a documented Environmental Management? Yes x No
If yes, please submit a copy of your environmental policy, sustainable procurement policy.

VII. HEALTH & SAFETY

Do you employ a H&S adviser, consultant? Yes x
No
If yes, please submit the name, qualifications and experience of the person/s.
Do you have a H&S policy manual? Yes Nox
If yes, please supply a signed and dated copy of the H&S policy statement.

VIII. REQUIREMENTS FOR ACCREDITATION (please mark/check requirements attached to this form)
Letter of Intent
Company Profile
Photocopy of Business Permit for the Year
Photocopy of SEC Certificate (if Partnership/Corporation)
Photocopy of BIR Certificate of Registration for VAT (BIR Form 2303)
Photocopy of Certificate of Appointment as Exclusive Distributor or Dealership from Principal (either local or
foreign) for each brand of specific product line being carried. Copy of any Agreement or Technical Service Support &
Assistance.
Sample blank copy of Sales Invoice / Official Receipt with BIR Permit No./TIN
Office, Plant & Warehouse Location Map and Photos
Table or Organization/Functional Chart
Sample copies of Purchase Order (At least 3 from Major Clients)
By-Laws and Articles of Partnership/Incorporation and General Information Sheet

X. OTHER REQUIREMENTS (Attach only if applicable)

Certified Test Reports (from Independent Testing Parties) for every product offered.
Distributors Certificate (for all Non manufacturers of both local & imported products)
Technical Brochures/Catalogues for Product/s offered (if not applicable, please supply the table below)

Please include a brief summary of goods or services that you supply. (Use separate sheets of paper if necessary)

TRANSPORT OF VARIOUS
EQUIPMENT AND GOODS
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NOTE: When completed, submit all hard copies bid in a long expandable folder with expandable
envelope. Submission will be every Thursday from 8:00 am to 5:00pm addressed to;
ARC Refreshments Corporation
Purchasing Department
3F Solmac Bldg. Banaue cor Dapitan St.,
Sto. Domingo, Quezon City

XI. REMINDERS
1. The application should be completed by all suppliers seeking registration as an approved goods/service
provider of ARC Refreshments Corporation. This however, does not guarantee business with ARC
Refreshments Corporation.
2. All the required supporting documentations must be submitted together with the Application Form.
3. ARC Refreshments Corporation reserves the right to reject any incomplete Application Form.
4. ARC Refreshments Corporation reserves the right to accept or reject any application without being obliged
to give any reasons in this respect.
5. All supplier information will be treated with strict confidentiality.
6. The completion of Supplier Accreditation Application Form is compulsory. Failure to complete this section
will result in your application not being considered.
7. ARC Refreshments Corporation reserves the right to validate the accuracy of information presented. Any
misrepresentation of facts will lead to disqualification.

The undersigned hereby confirms that the above information is true and correct, and that we
are the duly authorized to enter into this accreditation agreement and the supporting documents
attached hereto are genuine and authentic.

FRITZ VERNIE A. LAPASTORA

Signature over Printed Name Signature over Printed Name
Sales Manager President/Chief Executive Officer

Date Submitted