SUPPLIER QUALIFICATION FORM
Please complete all fields. Once submitted, your profile will be reviewed by the Pre-Assessment Unit.
Company Information
Company Name
ABN / Registration Number
Business Address
Primary Contact Name
Contact Email
Contact Phone Number
Business Profile
Number of Full-Time Employees:
1-10
11-99
100-499
500+
Annual Business Turnover:
Under $500,000
$500,000 - $2 million
$2 million - 10 million
over $10 Million
Please describe the materials or services you currently supply:
What is your monthly delivery or production capacity?
Have you previously supplied to government or large-scale contracts?
YES
NO
If yes, please describe:
Please provide proof of prior work (attach documents, photos, or reference letters):
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Additional Information
Do you have any relevant certifications or licenses?
Regions you are able to supply or deliver to:
Authorized Representative Name:
Position / Role in Company:
Signature
Date
-
Month
-
Day
Year
Date
I confirm that the above information is accurate and truthful.
Please verify that you are human
*
Submit
Form ID: DOF-QF-2218
This document is part of the Pre-Qualification Protocol under Section 9.3b of the Commonwealth Subcontractor Review Framework.