BASF INDIA LIMITED (CONSTRUCTION CHEMICALS DIVISION)

EVALUATION FORM FOR PROPOSED DISTRIBUTOR

Name of the Firm:

Head Office Address: Phone No: E-mail:

Sales Tax No & Date: Fax No: Website:

PAN No.:

Ownership type: Proprietorship/ Partnership/ Pvt Ltd/ Limited/ MNC/ Others

Management Team:
Name Designation Ownership, % Responsibility Experience Mobile No

How old is the firm? (No of years): Experience in CC (No of years):

Geographical Presence (Towns):

Statistics of the business:

Year Current Year Previous Year Previous Year - 1

Total Turnover (INR Mio)

CC Purchase (INR Mio)

Competition Share:

Supplier 1: 2: 3: 4:
Share in % of the total
business
Organization Resources & Infrastructure:

Shops/Showrooms (locations & area):

Warehouses (location & area):
Delivery vehicle (Type, No):
Sales Executives: Logistics Staff: Back-office Staff:
 Major Customers
Total Aggregate Sales Type Products sold
Name of the customer
(last one year) (type)

Proposed location of operation :

Proposed Target customer group:

Any other remark by regional distribution manager :

Distributor Section

Is the any BASF employee related (blood relation) to you or anyone in your organization
( Yes / No ) :
If yes , with whom & the relation :

Do you have adequate knowledge on BASF distribution management policies?

Do you agree with the advance payment terms of BASF India Limited?

Are business targets with you clearly defined to you ?

Sign:

Distributor ( Sign & Stamp ) (Proposed by ) (Distribution Manger )

Requisite enclosures: (tick on all enclosed)
□ 1 Brief Company profile
□ 2 Copy of company incorporation
□ 3 Pattern of promoter’s share holding
□ 4 Specimen signatures of all directors
□ 5 Photos of all directors
□ 6 Residence address proof of all
directors
□ 7 Name and address of the
bankers
□ 8 Certified P&L A/c & Balance
sheet (2 yr)
□ 9 Proof of sales tax registration
□ 10 Copy of pan card
□ 11 Credentials
□ 12 Others: 2 Blank security cheques
in the name of "BASF INDIA
LTD."