ACS Vendor Maintenance Form

Statement of compliance to the Honeywell code of conduct: There is no conflict of interest or any violation
of Honeywells code of conduct by the requestor who is wishing to have the supplier set up.
To ensure compliance with Honeywell Policy 2033 ,International Trade Compliance Policy I have used Visual
Compliance and confirmed this supplier is not on the U.S. Governments listing of Specially Designated Nationals
and Blocked Persons.

NEW VENDOR ADD NEW VENDOR SITE CHANGE INACTIVE (Inactive Date YYYY-MM-DD)
RE-ACTIVE One Time Vendor ( Please advice the inactive date if it is available)
227 Kings Shoe Manufacturing Pte Ltd 229 PT KSW Batam
230 PT Kings Safetywear 231 Kingshoe Manufacturing Sdn Bhd

VENDOR GENERAL INFORMATION:

*Supplier Name : PT. CALTEST ENGINEERS
(please do not use & in vendor
name or bank name)
Alternate Name : PT. CALTEST ENGINEERS
Site Name: : caltestengineers.com

*PAYMENT TERMS : Immediate Net 60 Days Back to Back

Net 7 Days Net 75 Days C/OFF60 Days
Net 14 Days Net 90 Days C/OFF90 Days
Net 30 Days Net 120 Days Other
*PAY GROUP : EXT-NORMAL Monthly (Default) INTERCOMPANY
*P.O. RELATED : Yes No
PFC CODE(SIC) :
*ADDRESS : Tunas Industrial Estate Block 2-V, Jl. Engku Putri Batam Centre, Batam
*CITY : Batam *POSTAL CODE :291462
*COUNTRY : Indonesia *CONTACT PERSON :Mr. Anoop. V. R
*TELEPHONE : +62 778 471 704 / 705 *FAX :+62 778 471 706
*REMITTANCE E-MAIL : anoopvr@caltestengineers.com
COMMUNICATION E-MAIL : anoopvr@caltestengineers.com, bhoopendh@caltestenginners.com
*CURRENCY : SGD USD THB
EUR MYR GBP
Other IDR
*PAYMENT METHOD : Wire Cheque Electronic
VENDOR TYPE : THIRD PARTY- THIRD PARTY - INTERCOMPANY
LOCAL OVERSEAS
: SUPPLIER GOVERNMENT Vendor-Global
SHIP TO LOCATION: : SHIP VIA :
BILL TO LOCATION: : BUSINESS REG.NUM :
HFOB (TRADE TERM) : EX-WORK FOB CRF CIF Others
FREIGHT TERMS : COLLECT PAID PREPAID Others

Liability Account -3rd (If blank, then default as 221150-00000-999999)

Liability Account - Interco (If blank, then default as 191/195xxx-00000-999999)

Requestor Approved by
Name & * EID Name & * EID

Dept Code
Date Date
 VENDOR BANK INFORMATION (For overseas suppliers, please indicate bank information on all invoices)
*Bank Name : BANK MANDIRI
*Bank Address Tunas Batam Centre,
*Bank Account Name (Beneficiary) PT. CALTEST ENGINEERS
*Account Number : 109 012 125 183
*Branch Name/Number -
Currency IDR
SWIFT Code BMRIIDJA
ROUTING No. : -

COMPANY SEAL & BANK AUTHORISED SIGNATORY

Name of Applicant: Mr. Vipin. P. G

Designation: President Director

Date: 24 Jun 2014

**FOR LOCAL SUPPLIER ONLY

KINDLY REQUEST YOUR BANK TO VERIFY THE PARTICULARS ABOVE BEFORE RETURING THIS COPY TO US

FOR BANK USE ONLY

WE HEREBY CONFIRM THAT THE ABOVE ACCOUNT NAME AND NUMBER IS CORRECT.

NAME OF BANK : MANDIRI

DATE:

BANK SEAL & AUTHORISED SIGNATORY