Vendor Application Form

VENDOR DETAILS

Vendor Type:

Name of the company or Individual:

Trading as Name:

Legal Entity Registration number:

VAT Registration number:

Postal Address:

Street Address:

Telephone Number:

Email address:

SECTION 1: GENERAL INFORMATION

Name of Bank:

Branch:

Branch code:

Account Holder Name:

Account Number:

Type of Account:

CONFLICT OF INTEREST

Zeitz MOCAA is committed to conducting business honestly and ethically which complies with all applicable legal requirements and expects the same from all suppliers. In support of these principles, disclosure of any actual or potential conflicts of interest and violations of honest and ethical business practices must be reported to the Finance Manager.

1. Are you or is any person connected with your business currently working at, affiliated to, or holds an interest in Zeitz MOCAA or any of the company subsidiaries? Yes No

REQUIRED DOCUMENTS

Stamped bank letter confirming your banking details (no older than 3 months):

ID document or Passport:

BBBEE Certificate or Affidavit:

Tax clearance certificate:

Company registration documentation:

ADDITIONAL DOCUMENTS (where applicable)

Transport: Passenger liability insurance:

Catering: Certificate of acceptability for food premises:

DOCUMENT DISCLAIMER

The information in this document is confidential and is legally privileged. It is intended solely for the purpose intended. Access to this document by unauthorized person is prohibited. If you are not the intended recipient, any disclosure, copying, distribution or any action taken or omitted in reliance on it, is prohibited and may be unlawful. While all reasonable steps are taken to ensure the accuracy and integrity of information and data transmitted electronically and to preserve the confidentiality thereof, no liability or responsibility whatsoever is accepted if information or data is, for whatever reason, corrupted or does not reach its intended destination. If you are a data subject of Zeitz MOCAA and you wish to engage with the Information Officer in respect of your rights under the Protection of Personal Information Act no.4 of 2013 (“POPIA”) or other statutes, please click here.

DECLARATION AND AUTHORISATION

By submitting, you agree not to hold Zeitz MOCAA accountable for any inaccuracies in the information you provide, and you commit to indemnify them against any resulting claims or losses.I undertake to advise Zeitz MOCAA in writing of any changes in the bank account details shown above or changes in ownership, which may occur. Ensure that your invoices and credit notes display the correct order number for timely payment processing. The Museum does not assume liability for payments without an official purchase order. Payment terms are standard at 30 days from the invoice date. I hereby confirm that I am duly authorised to complete this vendor application.

ZEITZ MOCAA REPRESENTATIVE

Full Name:

Designation:

Date: