Fine Tech Corporation Pvt Ltd (Logistic Division)

3rd Floor, Court House, LT Marg, Dhobi Talao

Mumbai - 400002
Application Form for Vendor Registration

INSTRUCTIONS
1. Please submit the form to the undersigned. Please ensure that the form is duly
completed before submitting. Form not properly filled in, is liable to be rejected.

2. Please write N. A. wherever not applicable.

3. If the space provided in the registration form is not sufficient, please attach separate sheets and
give Annexure reference number on the attached sheet.

4. Please enclose copies of certificate, reports etc wherever essential.

5. Please note, Reliance may register you if found suitable, but do not issue any certification of
registration number etc.
6. All the information is required unless otherwise stated.
7. Please do not fold the registration form.

8. Please submit the original duly filled form with all the supporting documents.

9. Pl. submit all the documents in A 4 size papers only, in a neat file folder.

02/25/2017
 1.General Details

1.1 Name of the Firm :

1.2 Name of group Company :

1.3 Name of Contact Person :

1.4 Contact Details : Address Line 1

(Please give address of Head Office) Address Line 2

Address Line 3

City District

State Country

Pin code

Phone No.1 ( )-

Phone No. 2 ( )-

Fax No. ( )-

Mobile No.

e-mail

1.5 Year of Establishment

1.6 IBA Approved * : Yes No

(* - Please attach a copy of IBA certificate) Please tick - a
1.6.1 Registration No.

1.6.2 Validity up to (Year)

 2.Company Profile

2.1 Type of the Firm (Pl.tick) :

Sole Proprietorship
Partnership
Pvt.Ltd.
Ltd.

2.2 Directors and Promoters :

(* - Please write the name of Director / CEO who is actively managing the company in 2.2.1)

2.2.1 Director / CEO * Name

Age
Qualification

Experience in this business

2.2.2 Director / CEO - 2 Name

(If necessary) Age
Qualification

Experience in this business

2.2.3 Director / CEO - 3 (if any) Name

(If necessary) Age
Qualification

Experience in this business

2.2.4 Director / CEO - 4 (if any) Name

(If necessary) Age
Qualification

Experience in this business

 3.Financial Details and Business Portfolio

3.1 Turnover details

(Please give the complete details of Business wise turnover in the table given below)
Type of Business Turnover in Rs Crores
(2009- 2010) (2010-2011) (2011-2012)
Express Cargo (Courier Services)
-1

LTL (Less Than Truck Load) - 2

FTL (Full Truck Load) - 3

Warehousign / C&F - 4

Logistics Solutions - 5

Total Transport business - 6 =

(1+2+3+4+5)
Other business - 7

Group - 8=(6+7)

3.2 Financial Position

3.2.1 Name of Bankers

3.2.2 Bank Guarantee Limit

3.2.3 Fund Based limits with Bank

3.2.4 Surplus Funds

Please tick a
10 - 20 Lakhs

20 - 30 Lakhs

30 - 40 Lakhs

40 - 50 Lakhs

> 50 Lakhs
 3.Financial Details and Business Portfolio

3.3 Income Tax Details

3.3.1 PAN No. (MANDETORY REQUIREMENT)

3.3.2 Last Assessment Order*

* - Please attach the copy of last year assessment copy.

3.4 Other Financial Details

Year------>>>> (2010- 2011) (2011-2012) (2012-2013)

Net Profit - Group

Net Worth - Group

Capital employed - Group

Debt-Equity Ratio - Group

Net Profit - Transport Business

Net Worth - Transport Business

Capital employed - Transport

Business

Debt-Equity Ratio - Transport

Business
 4.Location Details*
(* - Please use one sheet for giving address of one office.)

4.1 Type of the Office* :

(* - Please indicate the type of office as given in the table and mention the address of the office in point 4.2 given below
*TYPE OF OFFICE Head Office H.O.
Regional Office R.O.
Branch -- Own B.O.-own
Branch -- Attached B.O.-attached

4.2 Address of the Office : Address Line 1

Address Line 2

Address Line 3

City District

State Country

Pin code

Phone No.1 ( )-

Phone No. 2 ( )-

Fax No. ( )-

Mobile No.

e-mail

(Please mention the number of states being operated by the transporter. Also mention the states in next rows.)
4.3 Total No. of States operated :

4.4 Name of the States operated :

4.Location Details*
 5.Major Customer Details*

(* - Please give details of Contractual customers)

Name of the customer Industry Contract Contract start Turnover (2009-10) Turnover (2010-11) Turnover (2011-12)
since years up year
 6.Systems Details

6.1 Total no. of computers

6.2 Software used - Transport Yes No

6.2.1 Name of Software used (if yes)

6.3 Software used - Finance Yes No

6.3.1 Name of Software used (if yes)

6.4 Software used - Inter Office Work Yes No

6.4.1 Name of Software used (if yes)

6.5 System Orientation :

(Please Tick) ISO certified
Documented Procedures
No written procedures

7.Manpower Details

7.1 No. of employees

LocationManagersSupervisors Labour

HO

RO

Branches
 8. Fleet Details
PLEASE GIVE DETAILS OF ALL TYPES OF TANKERS WITH THEIR RESPECTIVE CAPACITY.
i.e. M.S., S.S., MS. RUBBERLINED, M.S. PRESSURISED etc.

PLEASE USE SEPERATE SHEET FOR EACH TYPE OF TANKER

TYPE OF TANKER:

Sr.No. Registration no. Capacity Year of Mfg. Own / attached

(MT)

NOTE:
Please attach copy of RC (Registration Certificate) for each vehicle mentioned above.
In the absence of RC Book Copy, the vehicle will not be considered.
YPES OF TANKERS WITH THEIR RESPECTIVE CAPACITY.

egistration Certificate) for each vehicle mentioned above.

 9.Claims Record

PARTICULAR 2010-2011 2011-2012 2012-2013

No. of truck lost

Total value of claim

(Rs.)
 10.Operating Details

Please attach one sheet for one state

Turnover No. of trips*
Name of state
Total Total Through own Through
trucks attached trucks

Total in state

Ex State

To State

Ex State to Gujarat & D

Ex State to Maharshtra

Ex State to Punjab

Ex State to UP(E)

Ex State to Orissa

Ex Gujarat & DNH to Sta

Ex Maharshtra to State

Ex Punjab to State

Ex UP(E) to State

Ex Orissa to State

Trip means one way trip e.g. - Truck moving from Mahrashtra to TN is one trip.
Same truck if returns from TN to Mahrashtra is second trip.
 11.Customer References

(please attach one sheet for one customer reference)

11.1 Name

11.2 Address

11.3 Contact Person

11.4 Telephone No.

11.5 Fax No.

11.6 e-mail

11.7 Approx. billing rang

11.8 State

THIS SHEET MUST BE SIGNED & STAMPED BY RESPECTIVE CUSTOMER

 DECLARATION

I/ We hereby certify that the particulars and statements submitted herein are true and
correct to the best of my/our knowledge and belief. I/We undertake to inform you at the
earliest any change in details mentioned thereof.

Signature :

Name :

Designation :

COMPANY SEAL :
OR STAMP

PLACE :

DATE :