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  • Section B
  • Section C

COMPANY INFORMATION

Legal Company Name

DBA Company Name

D & B DUNS Number

Physical Address

Street Address, Line 1, Line 2

City

State/Province/Region

Zip/Postal Code

Country

Company Phone Number (e.g. +1836171789)

Company Fax (e.g. +1836171789)

Company Website (www.companydomain.com)

CONTACT INFORMATION

Primary Contact Name

Title

Phone Number (e.g. +1836171789)

Best means of contact

Best Time To Contact:

Email Address (name@mycompanydomain.com)

BUSINESS INFORMATION

Company Ownership (Public/Private)

Have You Ever Provided Products Or Services To BPG

Type Of Entity

Type Of Business

Site/Location

Refinery Country

PRODUCT & SALES INFORMATION

Full Name of Product Being Offered

Basic Grade and Specifications

Single Metric Tonnage Per Shipment

Number Of Shipments Per Month

Contract Length

Delivery Mode Offered Incoterms 2010

Port of Discharge

Specify Additional Matters

CERTIFICATION
(N/B) Please Have Certification Documents Available Upon Request.

COMMERCIAL TERMS

Payment Currency Preferred

Name Of Bank

Street Address

City

State/Province

Zip/Postal Code

Country

Performance Guarantee

Performance Guarantee

FURTHER COMMENTS
On behalf of the company identified herein, the undersigned certifies all information listed on this form to be correct and true by pressing the Submit button.

Name (First Name, Last Name)

Title

Date.

NOTE: BPG, BLUEPALMGLOBAL, takes seriously its obligations to protect all personal data of its employees or other individuals that might provide personal information to the Company for business purposes. To that end, all vendors retained by BPG or its subsidiaries who are given access to individual personal information are contractually required to use appropriate procedures and specific safeguards to protect personal information against unauthorized access, use, or disclosure. Vendors must agree to comply with all applicable privacy and data protection laws. ACKNOWLEDGMENT: You acknowledge and agree that BPG is providing no guarantee that the business you are registering will receive any monetary or contractual benefit by registering on this site. To ensure your privacy, all information will be sent via a secure connection. We will not disclose any personal information to outside person(s) or entities unless we have written consent or unless authorized by law. Please see our Notice of Privacy Practices for more information.