New College Supplier Request Form

Please complete and submit the form below to request a new College Supplier

Your name:
Area of work:
Which best describes your position:
Other postion (please specify if not on drop down list)
Email:
Telephone:
Supplier Information
Supplier name:
Supplier address:
Suplier telephone:
Supplier email for orders:
Nature of the goods or services provided by proposed supplier:
Are the goods/services available from another preferred College supplier?	Yes	No
For audit purposes, please respond to the following statement: Do you or the person who has asked for this new supplier to be set up ahve any financial, pecuniary or other relationship with the supplier that may cause conflict of interest?	Yes	No
If the answer to the question above is yes, please provide further details:
Has your Head of Area or Area Administrator approved this request?	Yes	No
If yes, please provide name of approver:
Reason for request to add new supplier?
Value of first order in Euro:
How many orders do you propose to place with this supplier?
By submitting this request, you confirm that you have followed College purchasing competition regulations as set out at the following link: http://www.tcd.ie/procurement/policies.php

Trinity College Dublin