Supplier Expression of Interest

Supplier Expression of Interest

Please complete your application below. Fields marked with * are mandatory.

PART 1 – Supplier Information

1.1 Business Details

Registered Business Name: *
Trading As:
ACN No.:
ABN No.: *
Registered Trading Address:
Postal Address: *
Contact Number:*
Fax:
Company Type:
E-mail:
Date Business Commenced:
Are you an Aboriginal Business? *

An Aboriginal Business may be:

  • A sole trader, if the sole trader is an Aboriginal Person
  • A partnership or firm where at least 51% of the partners are Aboriginal persons
  • A corporation, where Aboriginal persons own at least 51% of the corporation
Are you registered on the Aboriginal Business Directory WA? *
If so, when did you register?
If you are an Aboriginal Business, are you:*
Please indicate your language group(s):*

PART 2 – Capability and Experience

2.1 Please provide details of two recent projects

Project 1
Project 1 Client Name:
Project 1 Project Location:
Project 1 Scope of Work:
Project 1 Project Duration (months):
Project 1 Contract Value ($):
Project 1 Client Contact Name:
Project 1 Contact Position:
Project 1 Contact Phone:
Project 1 Contact Email:
Project 2
Project 2 Client Name:
Project 2 Project Location:
Project 2 Scope of Work:
Project 2 Project Duration (months):
Project 2 Contract Value ($):
Project 2 Client Contact Name:
Project 2 Contact Position:
Project 2 Contact Phone:
Project 2 Contact Email:

PART 3 – Quality

11.1 Does your company currently have Quality Management System compliance with a recognised national or international standard such as the ISO AS/NZS 9001?*

PART 4 – Contact Details

Name: *
Position: *
Email:*
Phone Number:*