Common Supplier Registration Form - IAPSO



Annex I

Section 1: Company Details and General Information

1. Name of Company:

2. Street Address: 3. P.O. Box and Mailing Address:

Postal Code: City:

Country:

4. Tel: 5. Fax:

6. Email: 7. WWW Address:

8. Contact Name and Title:

9. Parent Company (Full legal Name) :

10. Subsidiaries, Associates and/or Overseas Representative(s) - (attach a List if necessary):

11. Type of Business (Mark one only) :

Corporate/ Limited: Partnership: Other (specify):

12. Nature of Business:

Manufacturer : Authorised Agent: Trader : Consulting Company: Other (specify):

13. Year Established : 14. Number of Full-time Employees:

15. Licence no./State where registered: 16. VAT No./Tax I.D:

17. Technical Documents available in :

English French Spanish Russian Arabic Chinese Other (specify) _________________

18. Working Languages :

English French Spanish Russian Arabic Chinese Other (specify) _________________

Section 2: Financial Information

19. Annual Value of Total Sales for the last 3 Years:

Year ______: USD___________million Year ______: USD___________million Year ______: USD___________million

20. Annual Value of Export Sales for the last 3 Years:

Year ______: USD___________million Year ______: USD___________million Year ______: USD___________million

21. Bank Name: Swift/BIC Address:

Address:

22. Bank Account Number: Account Name:

23. Please provide a copy of the company's most recent Annual or Audited Financial Report.

If available, please provide Credit Rating by Dun and Bradstreet or equivalent:

Section 3: Technical Capability and Information on Goods / Services Offered

24. Quality Assurance Certification (e.g. ISO 9000 or Equivalent) (please provide a Copy of your latest Certificate):

25. International Offices/Representation (Countries where the Company has local Offices/Representation):

26. For Goods only, do those offered for Supply conform to National/International Quality Standards?

Yes No

27. List below up to fifteen (15) of your Core Goods/Services offered:

UNCCS Code UNCCS Description (one Line for each Item) National/International Quality Standard

to which Item conforms

Section 4: Experience

28. Recent Contracts with the UN and/or other International Aid Organizations:

Organization: Value: Year: Goods/Services Supplied: Destination:

USD

USD

USD

USD

USD

29. To which Countries has your Company exported and/or managed Projects over the last 3 Years?

Section 5: Other

30. Does your Company have a written Statement of its Environmental Policy? (If yes, please attach a Copy)

Yes No

31. Please list any Disputes your Company has been involved in with UN Organizations over the last 3 Years:

32. List any National or International Trade or Professional Organizations of which your Company is a Member.

33. Certification:

I, the undersigned, hereby accept the basic UN General Conditions, a copy of which has been provided to me and warrant that the information provided in this form is correct, and in the event of changes details will be provided as soon as possible:

Name Functional Title

Signature Date

NOTE: Please be informed that a number of Procuring Entities of the UN system have decided not to do business with companies or any of their affiliates or subsidiaries, which engage in any practice inconsistent with the rights set forth in the convention on the Rights of the Child, regarding certain protection applicable to children performing work, or engage in the sale or manufacture of anti-personnel mines, or any significant component produced primarily for the operation thereof.

Please mail completed form to:

United Nations High Commissioner for Refugees

Supply Centre HQSF00

P.O. Box 2500

CH-1211 Geneva 2 Depot

Switzerland

INSTRUCTIONS FOR COMPLETION

The form should be typewritten in uppercase and completed clearly and accurately ensuring that all questions are answered. The numbers below correspond to item numbers on the registration form:

1. Full name of company.

2. Full street address.

3. Full mailing address (including P.O. Box, if any).

4. Telephone number, including correct country and area codes.

5. Fax number, including country and area codes.

6. Email address.

7. WWW Address.

8. Provide name of person (including title) or department to whom correspondence should be addressed.

9. Full legal name of parent company, if any.

10. Please provide, on a separate sheet if necessary, names and addresses of all subsidiaries, associates and overseas representatives if any.

11. Please tick one box. If the last box is ticked, please specify.

12. Please tick one box. If the last box is ticked, please specify. If the company is a manufacturer of some products and a trader/agent of others which they do not manufacture, both boxes should be ticked.

13. Indicate the year in which the organization was established under the name shown in Item 1.

14. Indicate the total number of full-time personnel in the company.

15. Provide the license number under which the company is registered, or the State where it is registered.

16. Provide the VAT number or Tax I.D. of the company.

17. Please tick the boxes for which languages the company is able to provide technical documents. Please specify other languages.

18. Please tick the boxes for which languages the company is able to work in. Please specify other languages.

19. Provide the total annual sales for the organization for the last 3 financial years in USD millions.

20. Provide the total export sales for the organization for the last 3 financial years in USD millions.

21. Provide the full name, address and SWIFT address of the bank used by the company.

22. Provide the company's bank account number and the account name.

23. Please provide a copy of your most recent annual report or audited financial report. If available, provide a rating by Dun and Bradstreet or equivalent (specify which).

24. List any Quality Assurance Certificates (e.g. ISO 9000 series) that have been issued to your company and provide a copy of the latest certificates.

25. List all countries where the company has local offices or representation.

26. Indicate whether the company's products conform to national/international standards. If yes please attach copies of the certificates.

27. Please list up to 15 of the core goods/services offered. If available, provide the UNCCS code and describe them according to the UNCCS description. For each item, list the National/International Quality Standard to which it conforms.

28. Enter the name(s) of UN organizations which your company has dealt with recently. Provide the value and the year of the contract, the goods/services supplied and the country of destination of each contract. If you have had more than 7 of such contracts, please attach a separate sheet indicating the others. Documentary evidence of such contracts is required, e.g. copies of purchase orders. Organizations in the UN system are: UN; UNCTAD; UNEP; UNCHS(Habitat); UNICEF; UNDP; WFP; UNHCR; UNRWA; UNFPA; UNOPS; UNU; ILO; FAO; UNESCO; ICAO; WHO; WB; IMF; UPU; ITU; WMO; IMO; WTO; WIPO; IAPSO; IFAD; UNIDO; IAEA; ITC; ECA; ECE; ECLAC; ESCAP; ESCWA.

29. List export markets, in particular, all developing countries to which your company has exported over the last 3 years.

30. The Earth Summit, held in Rio de Janeiro in 1992, emphasised the necessity to protect and renew the earth's limited resources. Agenda 21 was adopted by 178 governments and lays an emphasis for the UN to exercise leadership, i.a. towards promoting environmental sensitive procurement policies for goods and services. Please indicate whether your company has a written statement of its Environmental Policy and, if so, please provide a copy.

31. List all disputes with UN organizations which your organization has been involved in over the last 3 years. If more space is required, please use a separate sheet.

32. Provide details of all national and international trade or professional organizations to which your company belongs.

33. Please read the enclosed UN General Conditions carefully, as signature of the form signifies acceptance. The form should be signed by the person completing it and their name and title should be typed, along with the date.

General Conditions for Provision of Services (December 2003 version)

1. LEGAL STATUS

The Contractor shall be considered as having the legal status of an independent contractor vis-à-vis UNHCR. The Contractor, its personnel and sub-contractors shall not be considered in any respect as being employees of UNHCR. The Contractor shall be fully responsible for all work and services performed by its employees, and for all acts and omissions of such employees.

2. OBSERVANCE OF THE LAW

The Contractor shall comply with all laws, ordinances, rules, and regulations bearing upon the performance of its obligations under the terms of this Contract.

3. SOURCE OF INSTRUCTIONS

The Contractor shall neither seek nor accept instructions from any authority external to UNHCR in connection with the performance of its services under this Contract. The Contractor shall refrain from any action which may adversely affect UNHCR and shall fulfill its commitments with the fullest regard to the interests of UNHCR.

4. CONTRACTOR’S RESPONSIBILITY FOR ITS EMPLOYEES

The Contractor shall be responsible for the professional and technical competence of its personnel and will select, for work under this Contract, reliable persons who will perform effectively in the implementation of this Contract, respect the local customs, and conform to a high standard of moral and ethical conduct.

5. EXPLOITATION AND ABUSE OF REFUGEES AND OTHER PERSONS OF CONCERN TO UNHCR

The Contractor warrants that it has instructed its personnel to refrain from any conduct that would adversely reflect on UNHCR and the United Nations and from any activity which is incompatible with the aims and objectives of the United Nations and/or the mandate of UNHCR to ensure the protection of refugees and other persons of concern to UNHCR. The Contractor hereby undertakes all possible measures to prevent its personnel from exploiting and abusing refugees and other persons of concern to UNHCR. The failure of the Contractor to investigate allegations of exploitation and abuse against its personnel or related to its activities or to take corrective action when exploitation or abuse has occurred, shall entitle UNHCR to terminate this Contract immediately upon notice to the Contractor, at no cost to UNHCR.

6. ANTI-PERSONNEL MINES

The Contractor guarantees that it is not engaged in the sale or manufacture, either directly or indirectly, of anti-personnel mines or any components produced primarily for the operation thereof. Any breach of this representation and warranty shall entitle UNHCR to terminate this Contract immediately upon notice to the Contractor, at no cost to UNHCR.

7. CHILD LABOUR

The Contractor represents and warrants that neither it, nor any of its suppliers is engaged in any practice inconsistent with the rights set forth in the Convention on the Rights of the Child, including Article 32 thereof, which, inter alia, requires that a child shall be protected from performing any work that is likely to be hazardous or to interfere with the child’s education, or to be harmful to the child’s health and physical, mental, spiritual, moral or social development. Any breach of this representation and warranty shall entitle UNHCR to terminate this Contract immediately upon notice to the Contractor, at no cost to UNHCR.

8. SUB-CONTRACTING

In the event that the Contractor requires the services of one or more sub-contractors, the Contractor shall obtain the prior written approval of UNHCR for all sub-contractors. The Contractor shall be fully responsible for all work and services performed by its sub-contractors and suppliers, and for all acts and/or omissions of such sub-contractors and suppliers and their personnel. The approval of UNHCR of a sub-contractor shall not relieve the Contractor of any of its obligations under this Contract. The terms of any sub-contract shall be subject to and conform with the provisions of this contract.

9. ASSIGNMENTS

The Contractor shall not assign, transfer, pledge or make other disposition of this Contract or any part thereof or of any of the Contractor’s rights, claims or obligations under this Contract except with the prior written consent of UNHCR.

10. OFFICIALS NOT TO BENEFIT

The Contractor represents and warrants that no official of UNHCR has been, or shall be, offered by the Contractor any direct or indirect benefit arising from this Contract or the award thereof. The Contractor agrees that breach of this provision is breach of an essential term of this Contract.

11. ENCUMBRANCES/LIENS

The Contractor shall not cause or permit any lien, attachment or other encumbrance by any person or entity to be placed or to remain in any public office or with UNHCR against any monies due or to become due for any work done or materials furnished under this Contract, or by reason of any other claim or demand against the Contractor.

12. EXPORT LICENCE

If the services to be furnished under this Contract require the obtaining of any export licence or other governmental authorisation, it shall be the responsibility of the Contractor to obtain such licence or authorisation. Should the Contractor encounter difficulties in obtaining the required export licence or governmental authorisation, it shall immediately bring this to the attention of UNHCR. UNHCR will, at its discretion, use its best endeavours to assist.

13. WARRANTY

The Contractor warrants that the services furnished under this Contract comply with the applicable professional standards.

If works have to be carried out through the services furnished under this Contract, the Contractor warrants that the works conform to the specifications and are free from damage and defects in workmanship or materials. This warranty is without prejudice to any further guarantees that the Contractor provides under this Contract.

14. INSURANCE AND LIABILITIES TO THIRD PARTIES

The Contractor shall provide and thereafter maintain insurance against all risks in respect of its property and any equipment used for the execution of this Contract.

The Contractor shall provide and thereafter maintain all appropriate workmen's compensation insurance, or its equivalent, with respect to its employees to cover claims for personal injury or death in connection with this Contract.

The Contractor shall also provide and thereafter maintain liability insurance in an adequate amount to cover third party claims for death or bodily injury, or loss of or damage to property, arising from or in connection with the provision of services under this Contract or the operation of any vehicles, boats, airplanes or other equipment owned or leased by the Contractor or its agents, servants, employees or sub-contractors performing work or services in connection with this Contract.

Except for the worker’s compensation insurance, the insurance policies under this Article shall:

(a) Name UNHCR as additional insured;

(b) Include a waiver of subrogation of the Contractor's rights to the insurance carrier against UNHCR;

(c) Provide that UNHCR shall receive thirty (30) days’ written notice from the insurers prior to any cancellation or change of coverage.

The Contractor shall, upon request, provide UNHCR with satisfactory evidence of the insurance required under this provision.

15. INDEMNIFICATION

The Contractor shall indemnify, hold and save harmless, and defend, at its own expense, UNHCR, its officials, agents and other persons performing services on its behalf, from and against all suits, claims, demands, and liability of any nature or kind, including their costs and expenses, arising out of acts or omissions of the Contractor, or the Contractor’s employees, officers, agents or sub-contractors, in the performance of this Contract. This provision shall extend, inter alia, to claims and liability in the nature of workmen's compensation, products liability and liability arising out of the use of patented inventions or devices, copyrighted material or other intellectual property by the Contractor, its employees, officers, agents, servants or sub-contractors. The obligations under this provision do not lapse upon termination of this Contract.

UNHCR will promptly notify the Contractor of any such suit, claim, proceeding, demand or liability within a reasonable period of time after having received written notice thereof, and will reasonably co-operate with the Contractor, at the Contractor’s expense, in the investigation, defence or settlement thereof, subject to the privileges and immunities of UNHCR.

16. LIQUIDATED DAMAGES

Late delivery, or dispatch outside the agreed schedule, shall be subject, without notice, to an assessment of liquidated damages equivalent to 0.1 percent of the Contract value per day or part thereof. The assessment will not exceed 10 percent of the Contract value. UNHCR has the right to deduct this amount from the Contractor’s outstanding invoices, if any. This remedy is without prejudice to any others that may be available to UNHCR, including cancellation, for the Contractor’s non-performance, breach or violation of any term and/or condition of the Contract. Acceptance of services or works delivered late, shall not be deemed a waiver of UNHCR’s rights to hold the Contractor liable for any loss and/or damage resulting therefrom, nor shall it act as a modification of the Contractor’s obligation to make future deliveries in accordance with the delivery schedule.

17. REJECTION

In the case of services performed on scope of works, UNHCR shall have the right to reject the services or any part thereof if they do not conform to the scope of works.

18. COPYRIGHT, PATENTS AND OTHER PROPRIETARY RIGHTS

UNHCR shall be entitled to all intellectual property and other proprietary rights including but not limited to patents, copyrights, and trademarks, with regard to products, or documents and other materials which bear a direct relation to or are produced or prepared or collected in consequence of or in the course of the execution of this Contract. At UNHCR’s request, the Contractor shall take all necessary steps, execute all necessary documents and generally assist in securing such proprietary rights and transferring them to UNHCR in compliance with the requirements of the applicable law.

19. INTELLECTUAL PROPERTY INFRINGEMENT

The Contractor warrants that the use or supply by UNHCR of the services furnished under this Contract does not infringe on any patent, design, trade-name or trade-mark. In addition, the Contractor shall, pursuant to this warranty, indemnify, defend and/or hold UNHCR and the United Nations harmless from any actions or claims brought against UNHCR or the United Nations pertaining to the alleged infringement of a patent, design, trade-name or trade-mark arising in connection with the services furnished under this Contract.

20. TITLE TO EQUIPMENT

Title to any equipment and supplies that may be furnished by UNHCR under this Contract to the Contractor shall rest with UNHCR and any such equipment shall be returned to the United Nations at the conclusion of this Contract or when no longer needed by the Contractor. Such equipment, when returned to UNHCR, shall be in the same condition

as when delivered to the Contractor, subject to normal wear and tear. The Contractor shall be liable to compensate UNHCR for equipment determined to be damaged or degraded beyond normal wear and tear.

21. CONFIDENTIAL NATURE OF DOCUMENTS AND INFORMATION

All maps, drawings, photographs, mosaics, plans, reports, recommendations, estimates, documents and all other data compiled by or received by the Contractor under this Contract shall be the property of UNHCR, shall be treated as confidential and shall be delivered only to the authorized officials of UNHCR on completion of work under this Contract.

The Contractor may not communicate at any time to any other person, Government or authority external to UNHCR, any information known to it by reason of its association with UNHCR which has not been made public except with the authorization of UNHCR; nor shall the Contractor at any time use such information to private advantage. These obligations do not lapse upon termination of this Contract.

22. USE OF NAME, EMBLEM OR OFFICIAL SEAL OF UNHCR OR TE UNITED NATIONS

Unless authorised in writing by UNHCR, the Contractor shall not advertise or otherwise make public the fact that it has provided services to UNHCR and/or the United Nations, or use in any manner whatsoever the name, emblem and/or official seal of UNHCR and/or the United Nations or any abbreviation of the name of UNHCR and/or the United Nations in connection with its business or otherwise.

23. PRIVILEGES AND IMMUNITIES

Nothing contained in this Contract shall be deemed a waiver, express or implied, of any privilege or immunity which UNHCR may enjoy, whether pursuant to the Convention on the Privileges and Immunities of the United Nations, or any other convention or agreement.

24. TAX EXEMPTION

Section 7 of the Convention on the Privileges and Immunities of the United Nations provides, inter alia, that the United Nations, of which UNHCR is an integral part, is exempt from all direct taxes, except charges for public utility services, and is exempt from customs duties and charges of a similar nature in respect of articles imported or exported for its official use. In the event that any governmental authority refuses to recognize UNHCR exemption from such taxes, duties or charges, the Contractor shall immediately consult with UNHCR to determine a mutually acceptable procedure.

Accordingly, the Contractor authorises UNHCR to deduct from the Contractor's invoice any amount representing such taxes, duties or charges, unless the Contractor has consulted with UNHCR before the payment thereof and UNHCR has, in each instance, specifically authorised the Contractor to pay such taxes, duties or charges under protest. In that event, the Contractor shall provide UNHCR with written evidence that payment of such taxes, duties or charges has been made and appropriately authorised.

25. PRIOR NEGOTIATIONS SUPERSEDED BY CONTRACT

This Contract supersedes all communications, representations, arrangements, negotiations, requests for proposals and proposals related to the subject matter of this Contract.

26. OVERRIDING CLAUSE

In the event of any conflict or inconsistencies between these General Conditions for Provision of Services or any other document which forms part of this Contract, these Conditions shall prevail except where they have been amended (by specific reference to the relevant clause and paragraph of these Conditions) as provided for herein.

27. AUTHORITY TO MODIFY

Pursuant to the Financial Regulations and Rules of the United Nations, only the Head of the Supply Management Service possesses the authority to agree on behalf of UNHCR to any modification of or change in this Contract, to a waiver of any of its provisions or to any additional contractual relationship of any kind with the Contractor. Accordingly, no modification or change in this Contract shall be valid and enforceable against UNHCR unless provided by an amendment to this Contract signed by the Contractor and the Head of the Supply Management Service.

28. FORCE MAJEURE

In the event of and as soon as possible after the occurrence of any cause constituting force majeure, the Contractor shall give notice and full particulars in writing to UNHCR, of such occurrence or change if the Contractor is thereby rendered unable, wholly or in part, to perform its obligations and meet its responsibilities under this Contract. The Contractor shall also notify UNHCR of any other changes in conditions or the occurrence of any event which interferes or threatens to interfere with its performance of this Contract. On receipt of the notice required under this Article, UNHCR shall take such action as, at its sole discretion, it considers to be appropriate or necessary in the circumstances, including the granting to the Contractor of a reasonable extension of time in which to perform its obligations under this Contract.

If the Contractor is rendered permanently unable, wholly or in part, by reason of force majeure to perform its obligations and meet its responsibilities under this Contract, UNHCR shall have the right to suspend or terminate this Contract on the same terms and conditions as are provided for in Article 29 “Termination of Contract”, except that the period of notice shall be seven (7) days instead of thirty (30) days.

Force majeure as used in this provision means acts of God, war (whether declared or not), invasion, revolution, insurrection, or other acts of a similar nature or force.

Notwithstanding anything to the contrary in this Contract, the Contractor recognises that the works and services will be performed under harsh or hostile conditions caused by civil unrest. Consequently, delays or failure to perform caused by events arising out of, or in connection with, such civil unrest shall not, in and of itself, constitute force majeure under this Contract.

29. DISPUTES – ARBITRATION

Amicable Settlement The Parties shall use their best efforts to settle amicably any dispute, controversy or claim arising out of this Contract or the breach, termination or invalidity thereof. Where the parties wish to seek such an amicable settlement through conciliation, the conciliation shall take place in accordance with the UNCITRAL Conciliation Rules then obtaining, or according to such other procedure as may be agreed between the parties.

Arbitration Any dispute, controversy or claim between the Parties arising out of this Contract or the breach, termination or invalidity thereof, unless settled amicably under the preceding paragraph of this Article within sixty (60) days after receipt by one Party of the other Party's request for such amicable settlement, shall be referred by either Party to arbitration in accordance with the UNCITRAL Arbitration Rules then obtaining. The place of arbitration shall be Geneva. The arbitral tribunal shall have no authority to award punitive damages. In addition, unless otherwise expressly provided in this Contract, the arbitral tribunal shall have no authority to award interest. The parties shall be bound by any arbitration award rendered as a result of such arbitration as the final adjudication of any such controversy, claim or dispute.

30. TERMINATION OF CONTRACT

Either party may terminate this Contract for cause, in whole or in part, upon thirty (30) days’ notice, in writing, to the other party. The initiation of arbitral proceedings in accordance with Article 28 “Disputes - Arbitration” below shall not be deemed a termination of this Contract.

UNHCR may terminate forthwith this Contract at any time should the mandate or the funding of the Mission/Agency be curtailed or terminated, in which case the Contractor shall be reimbursed by UNHCR for all reasonable costs incurred by the Contractor prior to receipt of the notice of termination.

In the event of any termination by UNHCR under this Article, no payment shall be due from UNHCR to the Contractor except for work and services satisfactorily performed in conformity with the express terms of this Contract.

31. INSOLVENCY AND BANKRUPTCY

Should the Contractor become insolvent or should control of the Contractor change by virtue of insolvency, UNHCR may, without prejudice to any other rights and remedies, terminate this Contract by giving the Contractor written notice of termination.

Should the Contractor be adjudged bankrupt, or should the Contractor make a general assignment for the benefit of its creditors, or should a receiver be appointed on account of the Contractor’s insolvency,

UNHCR may under the terms of this Contract, terminate this Contract forthwith by giving the Contractor written notice of termination.

32. NOTICE

Service of any notice shall be deemed to be good if sent by registered mail or fax to the addresses of both parties, set out in the heading of this Contract.

33. PAYMENT INSTRUCTIONS

UNHCR’s normal terms are payment by bank transfer within thirty days of receipt of invoice in order.

Invoices are to be sent to the address indicated in the purchase order.

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