Vendor Registration Form

A. GENERAL INFORMATION

Company Type *

Main Category *

Company Name *

Company Address (as Deed of Establishment) *

Company Address (Correspondence / Domicile)

Office Phone Number *

E-mail Address *

Website Address

Company Size *Based on Annual Revenue

Company Description

B. GOODS AND SERVICES OFFERED

List the goods and services offered by your company *

Key Coverage Location *Select all applicable areas. Multiple selections allowed.

C. FINANCIAL OVERVIEW

NPWP / KTP Name *

NPWP Number / KTP ID ( If Personal ) *

Taxable Enterprise *

Nomor Induk Berusaha (NIB)

Klasifikasi Baku Lapangan Usaha Indonesia (KBLI)

D. VENDOR RELATIONSHIP

Name *

Position *

Office Phone Number *

Mobile Phone *

Email Address *

E. CONSENT

Please provide your Company Profile and a List of Past Project Portfolios for our evaluation and verification of your Company’s qualifications and competencies. These documents may be submitted via email to procurement@nwpproperty.com.

NWP Property is committed to conducting a fair, transparent, and ethical procurement process. Accordingly, all Prospective Vendors are expected to:

• Conduct business with honesty, integrity and refrain from any form bribery, corruption, collusion, or nepotism;

• Not offer, promise, provide or authorize the provision of gifts, money, entertainment, hospitality, special privileges, or any other benefits to any NWP Property employees, including but not limited to Procurement personnel, for the purpose of influencing the procurement process;

• Refrain from any attempt to improperly influence, interfere with, or communicate with any party involved in NWP Property’s procurement and vendor selection process;

• Not engage in collusive practices or any arrangement with other vendors intended to manipulate bidding prices or procurement outcomes;

• Ensure that all information, representations, certifications and supporting documentation provided are true, accurate, complete, and verifiable;

• Respect and honor the outcome of the vendor selection process and proceed in good faith with the execution of the relevant agreement, unless a legitimate and reasonable basis exists otherwise.

Any violation of the above requirements may result in disqualification from the procurement process, suspension or termination of vendor status, and/or other actions deemed appropriate by NWP Property in accordance with its polices and applicable law and regulations.

We hereby acknowledge and agree to comply with NWP Property’s Anti-Bribery, Anti-Corruption, and No-Gift Policy. Should our company identified to have violated these requirements, we acknowledge and accept that NWP Property may terminate our vendor registration and/or business relationship.

I hereby declare that all information and documentation submitted are true, accurate, complete, and provided in good faith. I acknowledge and agree that any omission, misrepresentation, falsification, or misleading statement may result in disqualification, termination of vendor status, and/or other appropriate actions by NWP Property

Please check the box below.