Supplier Vendor Application Form – Power Plant Services

Registered Company Name(Required)

Type of Organization

Company / General Email

Registered Place of Business Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone Number(Required)

Company Fax Number

Company Website

Under what other or former names has your organization operated?(Required)

What is the company’s DUNS number?(Required)

What is the company NAICS code?(Required)

Has the company ever defaulted on a contract?(Required)

In the last 5 years, has your company been involved in any cause of action such as claims, arbitration or lawsuits? (If you answered yes to this question, please submit details.)(Required)

Has the company acquired all necessary licenses required by law to manage its business and to supply products and services?(Required)

Have you been cited for major violations of laws resulting in monetary penalties and /or formal corrective actions mandated by a government authority or a court in the past 5 years? • regarding human rights and fair working conditions* • regarding environmental responsibility and sustainability* • regarding business integrity (e.g. fraud, bribery, antitrust, etc.)* • regarding export control provisions* • regarding intellectual property rights/business secrets*(Required)

Conflict of Interest

Does any PPS employee serve as an officer or director of this company?(Required)

Is any PPS employee a partner of this company?(Required)

Is any immediate family member (spouse or dependent child) of a PPS employee a partner or sole proprietor of this company?(Required)

Does any member of a PPS employees immediate family (spouse or dependent child) have an ownership interest of 10% or more in this company?(Required)

Does any PPS employee hold any paid position in this company?(Required)

If you answered yes to any of the questions in the "Conflict of Interest Statement", please identify the pertinent individual(s) and their relationship to this company

FORM SUBMITTER CONTACT INFO - As the submitter of this form, please enter your personal information:

Name (submitter)(Required)

First Last

Personal Email (submitter)

Personal / Direct Phone (submitter)

Details of your organization's scope of activity / products /services:

Number of months/years in the business:

Total Number of Employees:

Does this company belong to a group of companies? If yes, please list the company name

YES

NO

Company Name and Comments:

Does the company have several plants?

YES

NO

Please list plant details for locations:

How much is the average sales over the last 3 years

Do you have liability insurance?(Required)

YES

NO

Please provide a copy of your coverage showing the types, limits and ratings

Max. file size: 100 MB.

Have you reviewed and Do you agree to the terms and conditions outlined on our website at (https://go.ppsvcs.com/T-C)(Required)

YES

NO

Please attach a copy of a W9 document for tax purposes(Required)

Max. file size: 100 MB.

Is the company certified to a Quality Management system? If yes, please specify the standard, certifying body and provide a copy of your certificate. I Certificate is provided you may skip to section 3

Max. file size: 100 MB.

Does the company have any subsidiaries?

YES

NO

Please list subsidiary details:

Do you have a Quality Manual?

YES

NO

Do you have an internal and external audit program?

YES

NO

Do you have a staff training program/matrix?

YES

NO

The following questions relate to your Purchasing Process.

Do you have a controlled list of approved suppliers?

YES

NO

Comment:

Are your suppliers assessed and monitored?

YES

NO

Comment:

Are order quality requirements clearly defined?

YES

NO

Comment:

Are your suppliers in contract with you?

YES

NO

Comment:

KEY PERFORMANCE INDICATORS - Following Questions Regarding Key Performance Indicators in the last 12 months:

Have there been any accidents in the last 12 months?

YES

NO

Comment:

Has anyone been seriously harmed in the last 12 months? If so, how many?

YES

NO

Comment:

Please Provide the following information on your company's Quality Representative (please include: Name, Title, Email, Phone)

Please Provide the following information on your company's Sales and Customer Service member (please include: Name, Title, Email, Phone)

Attach a File (please zip multiple files into one zip file before attaching)

Max. file size: 100 MB.

BEFORE SUBMITTING THIS FORM: Please make sure you have answered ALL the questions as completely as possible. Omitting information on the form will only serve to delay the verification and approval process.

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Supplier Vendor Application

Power Plant Services is always ready for opportunity to serve both new and existing customers’ needs, delivering expertise and knowledge where it counts

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