Vizin Group Vendor Application

The Company described hereunder wishes to register as a Vendor with Vizin Group (Pty) Ltd.
The Applicant, as an authorised representative of the Company, is providing information, mentioned herein, before providing products or services to the company.
Failure to provide or update the requested information or to provide correct and accurate information may result in Vizin Group (Pty) Ltd rejecting the Application.
Kindly initial each page and sign in full on 4.

I, the undersigned, *
identity number *
in my capacity as *
of the Applicant, hereby declare and certify that, to the best of my knowledge: 1. all information set forth in this response is correct and complete, and the company and/or it representative will timely update its responses, as necessary, so that they remain at all times correct and complete; and
2. there are no prohibitions to the Company and /or its representatives purchasing products and/or services from Vizin Group (Pty) Ltd under any of the laws, regulations, local ordinances or rules of the proposed territory (including conflict of interest rules or bid conditions)
I further warrant that: a) I am authorised to sign this business application on behalf of the Applicant;
Signature of Applicant’s Authorised Representative (initials & surname) *
Print Name *
Title *
Email Address/Phone Number *
Date *

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