Supplier set up SVQ2 Questionnaire

1. ORGANISATION IDENTITY

1. Company Name:*

2. Contact name:*

3. Executive director/partner name/s*

4. Is the address outside the UK?:*

5. Address Line 1:*

6. Address Line 2:

7. Address Line 3:

8. Postcode/Zipcode:*

9. Town/City:*

10. Country:*

11. Telephone Number:*

12. Contact E-mail Address:*

13. Purchase Order E-mail Address:*

14. Remittance Email Address:*

15. Accounts Email Address:*

16. Company Registration No:*

17.Date of the Company Registration:*

18. VAT registration number:*

19. Is the Business or any part of the business located within the London Boroughs of Bromley, Lambeth and Southwark?:*

	Yes
	Νο
	Other

20 .Registered address if different from above (point 4):

21. UTR No.(Capital Suppliers only):

ATAMIS (registration required for all contracts over £10k)

All suppliers will need to register on Atamis the Health family eProcurement and Contract Management system.

Please refer to the supplier guide for more information. If you have any issues with your registration, please contact the Atamis support centre on 0800 9956035 or at support-health@atamis.co.uk

22.Please provide your Health Family Supplier ID (if applicable):

2. FINANCIAL

Please provide details of your bankers:

In addition to the below, please include a DUMMY INVOICE and at least 1 of the following:

·a screen shot of online banking showing bank details(Please note that the bank statements are not accepted )
·a scanned copy of a void cheque
·a paying in slip

(Screenshot covering transactions - only account details visible)

Please note above requirement is crucial to ensure that processes at KCH/KFM are completed effectively via the automated invoicing system. This is also to confirm that your invoice details meet our processing alignments and is also an audit application to ensure both parties (Supplier and Customer) are protected.

23.Supporting Documentation attachments(Dummy Invoice)*:

Max Size: 100MB

24.Supporting Documentation attachments*:

Max Size: 100MB

25. Bankers Name: *

26. Branch address: *

27. Account number: *

28. Sort Code: *

29. Currency:*

3. ORGANISATION INFORMATION

Please provide details of insurance protection in respect of each one the following:

30. What Goods and Services will your Company Provide?:*

31. Type of Organisation:*

Please note ALL fields are Mandatory to Complete.
*Required

Supplier Setup SVQ2 Questionnaire

1. ORGANISATION IDENTITY

ATAMIS (registration required for all contracts over £10k)

2. FINANCIAL

In addition to the below, please include a DUMMY INVOICE and at least 1 of the following:

3. ORGANISATION INFORMATION Please provide details of insurance protection in respect of each one the following:

3. ORGANISATION INFORMATION

Please provide details of insurance protection in respect of each one the following: