| Firm Name* |
|
| Contact Person* |
|
| Address |
|
| Country* |
|
| State* |
|
| City* |
|
| Telephone |
Area Code* |
|
Office* |
|
| Fax |
|
Mobile |
|
| E-mail* |
|
| Year of Establishment |
|
| Capital Employed (USD |
|
| Type of Company* |
Ltd. Company |
|
Partnership |
|
Self Owned |
| Type of Business |
Distributor |
Importer |
|
Wholesaler |
Buying Agent |
|
Retailer |
Manufacturer |
| Types of Items Dealt in |
Indian Raw Material |
Indian Spare |
|
Imported Raw Material |
Imported Spare |
|
Services |
Other |
| Leading Customers |
|
| List of Material |
|
| Production Capacity per month |
|
| Supply Capacity per month |
|
| Lab / Testing Facilities |
Yes |
No |
| Can Design Assistance be Extended |
Yes |
No |
| Whether Registered under ISO Certified |
Yes |
No |
| Are you associated with us as our Wholesale Customer |
Yes |
No |
| Have you supplied to Liberty Before |
Yes |
No |
Name & Address of Sister
Concern if any, who will
supply or have supplied
to Liberty |
|
| Bankers Address |
|
| Bankers Name |
|
| Preferable Mode of Payment |
Cash |
|
Cheque |
|
Demand Draft |
|
