ARMP Agence de Régulation des Marchés Publics APPLICATION FOR CNE
This form is available in our web site : http://www.amp.cm
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Service Provider
Business Name(*): _________________________________________________________
N° Taxpayer's Card(*): _____________________________________________________
N° Trade Register(*): _____________________________________________________
Legal Status(): Type of Enterprise() ______________________________________
Capital (figures in CFAF): _____________________________________________________
Localisation
Country: _________________________________________________________ City: _______________________________
Address(**): _________________________________________________________ P.O.BOX.: _________________________
Tel.(*): _________________________________________________________ Fax: _______________________________
E-mail(*): _________________________________________________________
Web site: _________________________________________________________
Information on the Public Procurement
Type Procedure(*): _________________________________________________________
Exercise(*): _________________________________________________________
Reference(*): _________________________________________________________
Project Owner(*): _____________________________________________________
Contracting Authority: ____________________________________________________
Subject(*): _________________________________________________________
Amount (in figures)*): ____________________________________________________
Date Signature(*): _________________________________________________________
Information on Payment
Banking Establishment *): (N° ARMP Account)
☐ UBA (N° 18004000204-95) ☐ Banaque Atlantique (N° 95101730005-10) ☐ CCEC-SA (N° 00003441001-28) ☐ SCB-CAMEROUN (N° 90000193116-91) ☐ BICEC (N° 97568660005-16) ☐ CCA BANK (N° 02372968601-31)
N° Receipt of Payment/Transferf(*): _______________________________________________
Date of Payment(*): _________________________________________________________
Documents attached to the Applications
Original Receipt of Payment/Transfer(): ☐ Yes ☐ No Copy of Taxpayer's Card: ☐ Yes ☐ No Copy of the Public Procurement (APO,OIT): ☐ Yes ☐ No Copy of Trade Register: ☐ Yes ☐ No
P.O Box.: 6604 Yaounde - Cameroon 222 20 18 03 / 222 20 00 08 / 222 20 00 09 222 20 60 43 / 222 20 33 26 info@amp.cm www.amp.cm Platform: pridesoft.amp.cm Date: _________________________ I hereby declare the above information exact STAMP SIGNATURE AND NAME HERE