ZPC OFFICIAL FORMS REF: ZOF

VENDOR INFORMATION SHEET

FORM SPECIFICATIONS

Name Vendor Information Sheet (VIS) Form Number F.N. 110.2012.00

Padd Loose Continuous
Number of copies 2 Number of sets per pad (if padded)
Pre- ed Leaf Form
Comments/Description/Printing Instructions:
numbered
Need not be pre-printed.

Sample format
Copies Size Color Paper Quality reference
1 8 1/2 X 11 inches White standard bond paper Attachment 1
2 8 1/2 X 11 inches White standard bond paper Attachment 1

Prepared by: Role Signature Date

MARIE ANNE S. FERRERIA ZPC SOAR System Integration

and Documentation Team
Corporate Systems Assistant Manager Lead (Back-up)

LEIGH KENNETH D. RUGNAO ZPC SOAR System Integration

and Documentation Team
Corporate Systems Analyst Member

DIWATA N. DE LEON ZPC SOAR System Integration

and Documentation Team
Corporate Systems Manager Lead

Reviewed and Endorsed by: Role Signature Date

JOSEPH ANTHONY F. ROSELLO Subject Matter Expert and

ZPC SOAR Sales Functional
Account Manager Team Member

JEOGLIN T. CASINILLO ZPC SOAR Sales

Group Sales Manager Stream Lead

MA. ROWENA GRACE B. BELEN ZPC SOAR Operations

Manager - Customer Service & Business Development Stream Lead

GARRY B. GALVEZ
Subject Matter Expert
Supply Chain Director

MARISOL D. EMBALSADO
Subject Matter Expert
Principal Accounting Manager

MARION S. SANTIAGO
Subject Matter Expert
Principal Accounting Manager

EUGENE M. BALAYAN ZPC SOAR Finance

Operations Controller Stream Lead

JOEL R. DUCUT
ZPC SOAR Team Lead
Assistant Corporate Controller

Approved by: Role Signature Date

MARIA VISITACION I. BARREIRO ZPC SOAR OCM Team Lead

AVP - Corporate Controller (Back-up)

ASHLEY GERARD S. ANTONIO ZPC SOAR Steering

VP - Distribution Committee Member

JOSEPH NATHANIEL B. AGUILAR ZPC SOAR

Chief Operations Officer Project Sponsor
 Reference No.

VENDOR INFORMATION SHEET <to be assigned by Zuellig Pharma>

Page 1 of 3
TO BE FILLED OUT BY ZUELLIG PHARMA
Vendor Code Type of Application Date of Application
New Update Renewal

COMPANY PROFILE
VAT Registered?
Business Name
YES If yes:
12%
Business VAT
Zero-
Sole Corporatio
Ownership Partnership
(Please check one) Proprietorship n rated
NO
Registration Date Please attach 2x2 picture
(for Single Proprietor only)

Building Name & Local Address

Room No. Building Name & Room No.

No. & Street

No. & Street
Barangay or Subdivision or
Barangay or Subdivision or District
District
Town / City / Province
Business Address Town / City / Province
Zip Code
and Business
Contact Numbers Zip Code

e-Mail Address e-Mail Address

Telephone No./s Telephone No./s

Fax No./s Fax No./s

Cellular Phone No. Cellular Phone No.

Registration Numbers
SEC DTI Municipal/Business Permit BIR / Tax Identification Number SSS

Payment Arrangement
(Please check one)
For cheque payment (please choose preferred For bank transfer to
releasing Account
Bacolod center): Davao account:
San Fernando ZPC Cash Number
Branch Branch
Gen Santos Branch
San Pablo Department Account
Butuan Branch Name
Branch Branch This option requires prior approval
Canlubang Iloilo Branch Sucat of the AVP-Corporate Controller. Branch
Cauayan Tacloban
Legaspi Branch AVP-Corporate Controller
Branch Ozamis Branch Note: This is only available for Bank of the Philippine Islands
CDO Branch Zamboanga Branch depository banks. Please provide Letter of Intent and Business
Branch
Pangasinan Registration to Corporate Finance.
Cebu Branch HSBC
Branch
ORGANIZATIONAL STRUCTURE
Senior Management Personnel Designation
(Last Name, First Name, Middle Initial)
1

COMPANY'S FINANCIAL INFORMATION

Bank Name Branch Account Type

Properties Owned Description/Location Insurance Company Amount Insured

Real Estate (Land/Building)

Shares of Stocks

Other Assets

F.N. 110.2012.00 Distribution: 1 - Master Data Team

 Reference No.

<to be assigned by Zuellig Pharma>

Page 2 of 3

LIST OF COMPANY MEMBERSHIP

Name of Organization From To Name of Officer Office Held
1

LIST OF COMPANY AFFILIATES

Company Name Since When? Type of Business Contact Person Contact Number
1

LIST OF COMPANIES SERVED / BEING SERVED

Year of Service
Company Name Type of Service Contact Person Contact Number
From To
1

BUSINESS REFERENCES
Company Address Contact Person Designation Telephone No.

PROFILE OF COMPANY'S POINT PERSON

Full Name Position
(Last Name, First Name Middle Initial)

Birthdate Nationality
(MM/DD/YYYY)
Building Name &
Room No.
No. & Street

Barangay or
Subdivision or District
Address and Contact
Numbers Town / City

Province

Zip Code e-Mail Address

Telephone No./s
Cellular Phone No.
Fax No.s
CERTIFICATION
I hereby certify that all the information supplied by my company on this form are true and correct. Should any untruths be
discovered, my company fully agrees that Zuellig Pharma has the discretion to use such act as basis to revoke my accreditation.

Certified by Date Signed

Signature over Printed Name

F.N. 110.2012.00 Distribution: 1 - Master Data Team
 Reference No.

<to be assigned by Zuellig Pharma>

Page 3 of 3

To be accomplished by ZUELLIG PHARMA

CLASSIFICATION
For Principal maintenance only
DIP (Direct CSM
Business Mode
Purchase) (Consignment)
ACCOUNTING INFORMATION
1703060 (Receivable from Principals - Service
Income) K1 (A/P
Reconciliation 2207010 (Trade Payables - Third Cash Management Principal)
Account Party) Group K2 (Non-trade
2212010 (Other Payables - Third Vendors)
Party)
PAYMENT TRANSACTION (GENERAL)
1 HSBC_MKT (Reference: PICK BANK) 2 HSBCPHMM
Instruction Key
and Bank Key 48 HSBCPHMM

PAYMENT TRANSACTION (COMPANY CODE)

C (Check-
Payment Terms outgoing)
O (Check-
For Principal maintenance only Payment Methods outsourcing)
Clearing with T (Bank
Customer? YES NO
Transfer)
CORRESPONDENCE
Accounting Clerk
(Note: For Principal
maintenance only) Clerk at Vendor

Clerk's Telephone

WITHHOLDING TAX

Subject to tax? NO YES Tax Code _______

PURCHASING DATA
PHP (Philippine
Order Currency USD (US Dollars) Others __________
Peso)

Incoterms
PD (ZP PH Domestic PI (ZP PH Import
Schema Group Vendor) Vendor)

ZUELLIG PHARMA ATTRIBUTES (For Principal maintenance only)

IMS Extraction YES NO
PD/Sales Team Principal Contractual Level in
Flag? Code Days
Average Sales Historical Forecast Under Approval YES
Computation in Months in Months Process (PPA) NO

Submitted by Date Checked by Date

Proponent Department Manager

Signature over Printed Name Signature over Printed Name

Completed by Date Noted by Date
Designated Corporate Finance Personnel Assistant Corporate Controller or
Management Accounting Manager

Signature over Printed Name Signature over Printed Name

Maintained by Verified by
Credit Supervisor File Maintenance Analyst Master Data Team (Supervisor / Manager)

Signature over Printed Name / Date Signature over Printed Name / Date Signature over Printed Name / Date
F.N. 110.2012.00 Distribution: 1 - Master Data Team
 PAYMENT TERMS
Code Description Code Description Code Description
D000 Due on the same day D125 Due after 125 days F090 Due after 90 days - EOM
D001 Due on the next day D127 Due after 127 days F105 Due after 105 days - EOM
D007 Due after 7 days D130 Due after 130 days F120 Due after 120 days - EOM
D010 Due after 10 days D135 Due after 135 days F150 Due after 150 days - EOM
D014 Due after 14 days D137 Due after 137 days F180 Due after 180 days - EOM
D015 Due after 15 days D140 Due after 140 days G001 Payable in 2 Installments (50%-50%, 75-105 days)
D025 Due after 25 days D150 Due after 150 days G002 Due 75 Days from Invoice, cut-off 15th
D030 Due after 30 days D165 Due after 165 days G003 Due 105 Days from Invoice, cut-off 15th
D035 Due after 35 days D175 Due after 175 days G004 Payable in 2 Installments (50%-50%, 61-91 days)
D037 Due after 37 days D180 Due after 180 days G005 Due 61 Days from Invoice, always pay on 1st
D039 Due after 39 days D185 Due after 185 days G006 Due 91 Days from Invoice, always pay on 1st
D045 Due after 45 days D210 Due after 210 days G007 Payable in 2 Installments (50%-50%, 33-63 days)
D047 Due after 47 days D240 Due after 240 days G008 Due 33 Days from Invoice, always pay on 3rd
D053 Due after 53 days D270 Due after 270 days G009 Due 63 Days from Invoice, always pay on 3rd
D054 Due after 54 days D285 Due after 285 days G010 Due 15 Days from Invoice, cut-off 15th
D055 Due after 55 days E010 Due 10 days from EOM G011 Due 30 Days from Invoice, cut-off 15th
D056 Due after 56 days E025 Due 25 days from EOM G012 Due 60 Days from Invoice, always pay on 20th
D058 Due after 58 days E030 Due 30 days from EOM G305 Due after 30 days - Every 5th of the Month
D059 Due after 59 days E033 Due 33 days from EOM G315 Due after 30 days - Every 15th of the Month
D060 Due after 60 days E035 Due 35 days from EOM G602 Due after 60 days - Every 2nd of the Month
D062 Due after 62 days E039 Due 39 days from EOM G605 Due after 60 days - Every 5th of the Month
D063 Due after 63 days E045 Due 45 days from EOM I007 Due 7 days from PRN Invoice
D065 Due after 65 days E054 Due 54 days from EOM I015 Due 15 days from PRN Invoice
D067 Due after 67 days E058 Due 58 days from EOM I030 Due 30 days from PRN Invoice
D068 Due after 68 days E060 Due 60 days from EOM I045 Due 45 days from PRN Invoice
D070 Due after 70 days E062 Due 62 days from EOM I060 Due 60 days from PRN Invoice
D075 Due after 75 days E065 Due 65 days from EOM I065 Due 65 days from PRN Invoice
D080 Due after 80 days E070 Due 70 days from EOM I075 Due 75 days from PRN Invoice
D083 Due after 83 days E075 Due 75 days from EOM I080 Due 80 days from PRN Invoice
D085 Due after 85 days E080 Due 80 days from EOM I090 Due 90 days from PRN Invoice
D089 Due after 89 days E083 Due 83 days from EOM I095 Due 95 days from PRN Invoice
D090 Due after 90 days E090 Due 90 days from EOM I100 Due 100 days from PRN Invoice
D091 Due after 91 days E091 Due 91 days from EOM I120 Due 120 days from PRN Invoice
D092 Due after 92 days E095 Due 95 days from EOM I130 Due 130 days from PRN Invoice
D093 Due after 93 days E120 Due 120 days from EOM I135 Due 135 days from PRN Invoice
D095 Due after 95 days E122 Due 122 days from EOM I145 Due 145 days from PRN Invoice
D097 Due after 97 days E150 Due 150 days from EOM I150 Due 150 days from PRN Invoice
D100 Due after 100 days F000 Due on Fixed Date I175 Due 175 days from PRN Invoice
D105 Due after 105 days F030 Due after 30 days - EOM I180 Due 180 days from PRN Invoice
D110 Due after 110 days F045 Due after 45 days - EOM I210 Due 210 days from PRN Invoice
D111 Due after 111 days F059 Due after 59 days - EOM I240 Due 240 days from PRN Invoice
D115 Due after 115 days F060 Due after 60 days - EOM M030 Due 30 days from EOM
D116 Due after 116 days F062 Due after 62 days - EOM M060 Due 60 days from EOM
D120 Due after 120 days F073 Due after 73 days - EOM M090 Due 90 days from EOM
D121 Due after 121 days F075 Due after 75 days - EOM MI50 Payable in 2 Installments (50%-50%)
 Contact Person (BRANCH) Department Name1 (Branch) Search Term1 c/o
ZP-BACOLOD BRANCH HSBC ZP-BACOLOD BRANCH BACOLOD Roselie Lim
ZP-BUTUAN BRANCH HSBC ZP-BUTUAN BUTUAN Justiniano Valderama
ZP-CANLUBANG HSBC ZP-CANLUBANG CANLUBANG Cleofel Oliver
ZP-CAUAYAN BRANCH HSBC ZP-CAUAYAN BRANCH CAUAYAN Charlotte Dela Cruz
ZP-CDO BRANCH HSBC ZP-CDO BRANCH CDO Jean Aclan
ZP-CEBU BRANCH HSBC ZP-CEBU BRANCH CEBU Leah Clarete
ZP-DAVAO BRANCH HSBC ZP-DAVAO BRANCH DAVAO Susan Tomimbang
ZP-GEN SANTOS BRANCH HSBC ZP-GEN SANTOS BRANCH GENSAN Donalyn Villarica Cometa
ZP-ILOILO BRANCH HSBC ZP-ILOILO BRANCH ILOILO Michelle Tremucha
ZP-LEGASPI BRANCH HSBC ZP-LEGASPI BRANCH LEGASPI Janet Bataller
ZP-OZAMIS BRANCH HSBC ZP-OZAMIS OZAMIS Judith Flores
ZP-PANGASINAN BRANCH HSBC ZP-PANGASINAN BRANCH PANGASINAN Remedios Bautista
ZP-SAN FERNANDO BRANCH HSBC ZP-SAN FERNANDO BRANCH SANFER Fausto De La Cruz
ZP-SAN PABLO BRANCH HSBC ZP-SAN PABLO SAN PABLO Ms. Leonie Dorado
ZP-SUCAT HSBC ZP-SUCAT SUCAT Maricel Concepcion
ZP-TACLOBAN BRANCH HSBC ZP-TACLOBAN BRANCH TACLOBAN Rimma Macariola
ZP-ZAMBOANGA BRANCH HSBC ZP-ZAMBOANGA BRANCH ZAMBOANGA Petsybelle Fabian
 Street 2 Street 3 Postal Code City Region
MBG Bldg LSM House Hilado Ext. Capitol Shopping Center 6100 Bacolod City VIS
Marsman Dist. Ctr, 2nd Flr. Cor Amelia Sulpicion st. Luz Village 8600 Butuan City MIN
Bo. Diezmo, Terely Phase, Canlubang Industrial Estate, Cabuyao 4028 Laguna LUZ
Isabella Leaf Tabacco Co. (LTC) Cmpd. Maharlika High-way Frenza, Cauayan 3305 Isabela LUZ
Lolita Building Chali Beach Cugman 9000 Cagayan De Oro MIN
Dr. F.E Zuellig Ave. Corner Circumferrencial Road, New Mandaue City 6014 Cebu VIS
Lot 1-E-7D Dela Paz St. Brgy R. Castillo Agdao Dist. 8000 Davao City MIN
Archade 2, 2nd Flr East Asia Royal Hotel Nat'l Hiway 9500 General Santos City VIS
Sportsville Bennigno Aquino Nat'l High-way, Sambag Jaro 5000 Iloilo City VIS
3rd flr, Diabetes One Stop Center Lanco Business Park Capatawan 4500 Legaspi City LUZ
City Hall Drive,Don Anselmo Bernad Ave (fka Don Mariano Marcos Ave) 7200 Ozamis City MIN
Bo. Anolid Mangaldan Near Dagupan Mangaldan Boundary 2432 Pangasinan LUZ
4th Floor, LKG Bldg. Brgy. Dolores San Fernando City 2000 Pampanga LUZ
YKK Bldg. Km, 82 Maharlika Highway Brgy.San Gabriel, San Pablo City 4000 Laguna LUZ
Km21 West Service Rd. Villoco Rd Southbay Subd., Sucat 1770 Muntinlupa City LUZ
MBG Bldg LSM House Hilado Ext. Hiway, Diversion Rd, Brgy Utap 6500 Tacloban City VIS
Benjamin Go Bldg. Abelardo Climaco St. Talon-talon Loop 7000 Zamboanga City MIN
Country
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PH
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 WITHHOLDING TAX CODE
Code Description
21 C010-10% EWT on profnls-corp < 720k
22 C011-15% EWT on profnls-corp > 720k
23 C050-10% EWT mgt/tech consltnt-corp<720k
24 C051-15% EWT mgt/tech consltnt-corp>720k
25 C100-5% EWT on rentals-corp
26 C120-2% EWT on contractors-corp
27 C140-10% EWT Pd to Brokers/Agents(Corp)
28 C158-1% EWT Paym by top 10K-corp-goods
29 C160-2% EWT Paym by top 10K-corp-Svcs
41 I010-10% EWT on professionals-ind-<720k
42 I011-15% EWT on professionals-ind->720k
43 I050-10% EWT mgt/tech consltnt-ind-<720k
44 I051-15% EWT mgt/tech consltnt-ind->720k
45 I100-5% EWT on rentals (ind)
46 I120-2% EWT on contractors (ind)
47 I140-10% EWT Pd to Brokers/Agents(Ind)
48 I141-10% EWT med practitioner-ind-<720k
49 I142-15% EWT med practitioner-ind->720k
50 I150-15% EWT med/dent svc-hosp/cl>720k
51 I151-10% EWT med/dent svc-hosp/cl<720k
52 I158-1% EWT Paym by top 10K corp goods
53 I160-2% EWT Paym by top 10K corp-Svcs