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Supplier Registration Form _____________________________________________________________________________

Supplier Registration Interested parties are welcome to register with the Airport Authority ("AA") as potential suppliers ("Applicants"). Parties seeking to have business with AA shall complete a "Supplier Registration Form" ("Form") in full and attach all the required enclosures (e.g., business registration certificate, customer reference, etc). Details of Applicants such as their company profiles, goods, and services will be maintained for 3 years to facilitate coming contact and sourcing purposes. The completed Form and required enclosures shall be forwarded to the following address in a sealed envelope marked "CONFIDENTIAL". Airport Authority HKIA Tower, 1 Sky Plaza Road Hong Kong International Airport Lantau, Hong Kong Attn: Ms. Jacqueline Lam Senior Manager, Procurement

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Supplier Registration Form _____________________________________________________________________________

Supplier Registration Form

AA's Ref. No. : ________________

Date : ___________________

1. Company Name : 2. Address :

3. Tel. No : 4. Person(s) to contact 4.a.) Name : Position : Tel No. : E-mail : 4.b.) Name : Position : Tel No. : E-mail : 5. Business Registration Certificate No. Valid until 6. Brief Description of Company 6.a.) Year of Establishment: 6.b.) No. of Staff 6.c.) Nature of Business

Fax No :

Fax No. :

Fax No. :

( Please attach a copy )

6.d.) Annual Turnover (pls attach supporting documents) HK$

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Supplier Registration Form _____________________________________________________________________________ 6.e.) List of Goods/Services ( indicate with # mark for those items under Sole Agency / Exclusive Distributorship / OEM, and attach documentary proof )

6.f.) Major Customers* ( Please attach Supplier Performance Questionnaire and Customer Reference duly completed by your major customers ) Name Address Contact Person i



*Note: The Authority reserves the right to contact those companies listed as customer reference without giving any prior notice to the Applicant. By completing and submitting the Form, the Applicant thereby authorizes those companies to release information relating to the customer reference listed.

6.g.) Please indicate (*delete as appropriate) if you are interested to be assessed and included in the Authority's Lists of Pre-Qualified Tenderers for Future Construction Works at HKIA; a pre-qualification exercise will be carried out separately. i. Under Building Works Category ­ INTERSTED / NOT INTERESTED* ii. Under Civil Engineering Works Category ­ INTERESTED / NOT INTERESTED*



Autopay Details Bank Name:


Bank Address:

Bank Account No.: Bank Code: Bank Branch Code: Bank SWIFT Code:

AutoPay Details : Please note that if no autopay details are received from your company, the Authority will make payment via cheque or bank draft to your address by ordinary mail. Once the above bank account is confirmed and updated in our payment system, we shall pay accordingly. Any

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Supplier Registration Form _____________________________________________________________________________

subsequent change of bank account should be notified in writing to Authority in advance by your company's authorized representative(s). Please allow at least two weeks time for the Authority to process and implement such change of bank account.


We/I* give both the names of employees of the Airport Authority and/or their families who are related to us/me*, or to our/my* employees and/or* their families, and the nature of their relationship. (State none if totally inapplicable)

9. We/I* understand that all employees of the Airport Authority are designated "public servants' under the provisions of the Prevention of Bribery Ordinance (Chapter 201) of the Laws of Hong Kong. 10. We/I* understand that offering or giving any gratuity, bonus, discount, bribe, loan or any other gift or consideration as an inducement or reward to any employee of the Airport Authority in relation to any Airport Authority contract could constitute an offence contrary to the Prevention of Bribery Ordinance Chapter 201, and that if we/I* are found to have made such an offer, the Airport Authority shall be at liberty to cancel the contract and shall hold the supplier liable for any loss or damages which the Airport Authority may thereby sustain.

*Delete as appropriate

Authorized Signature Name (in Block Letter) Position Held Company Chop Date Enclosures: Business Registration Certificate (Item no.5 above); Annual Turnover Information (Item no.6.d above); Documentary proof of Sole Agency / Exclusive Distributorship / OEM (Item no.6.e above); Supplier Performance Questionnaire and Customer Reference (Item no.6.f above); Others, if any.

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