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BIDFOOD COVID-19 Payment Relief Plan – APPLICATION

AUTHORISATION TO PROVIDE INFORMATION


Please note: This form needs to be completed by capturing all required information at once and does not auto-save the information at this point in time. Please download a copy of the form so that you can collate your information and submit to us when ready. Bidfood Payment Relief Plan Form

Entity Details


Registered/Legal Name
*
Trading Name


Registration Number
*
Entity Type
*
Vat Number
*  

Tax number
*
Tax Clearance?
*
If yes, Tax Clearance pin

Customer Industry
*


Physical Address
*
Registered Address
*

Postal Code
*  
Postal Code
*  



Entity Banking Details


Banking Institution
*
Account Number
*
Branch code
*

Information


Authorised representative
*
Bidfood Account no.
*


Email address
*


Telephone Number
Cellphone number
*


Bidfood Branch
*
Total outstanding debt with Bidfood
*




By ticking this box you warrant that you are duly authorised to act on behalf of the Entity and hereby authorise Bidfood (Pty) Ltd to approach the Entity’ bank provided for above to obtain credit information, which in this instance means only the bank’s credit rating of the customer as well as the support the bank potentially envisages the customer receiving in terms of bank support and government support (as specified by the client). Information obtained will be kept strictly confidential between the parties and will be solely only be used for the purposes of assessing the Entity with regards to any Covid-19 relief being considered. *

Landlord Details


Property Leased or Owned
*
Owned
Property value

Bond Value

Banking Institution

Leased
Name of landlord


Contact details of landlord

Lease re-negotiated due to Covid-19?

If yes provide details
Payment Holiday negotiated due to Covid-19?

If yes provide details

Financial Information

Have you applied for any financial support services from any of the below:

Banking institution


Covid-19 Initiatives



If yes to any of above, provide details of assistance applied for and assistance received


Last 13 months income and expense

If Nil insert 0
Month
Turnover
Food Cost
Rental
Labour Cost
Finance Cost
Other Expenses
Net Profit/Loss
March 2019
*  
*  
*  
*  
*  
*  
April 2019
*  
*  
*  
*  
*  
*  
May 2019
*  
*  
*  
*  
*  
*  
June 2019
*  
*  
*  
*  
*  
*  
July 2019
*  
*  
*  
*  
*  
*  
August 2019
*  
*  
*  
*  
*  
*  
September 2019
*  
*  
*  
*  
*  
*  
October 2019
*  
*  
*  
*  
*  
*  
November 2019
*  
*  
*  
*  
*  
*  
December 2019
*  
*  
*  
*  
*  
*  
 
January 2020
*  
*  
*  
*  
*  
*  
February 2020
*  
*  
*  
*  
*  
*  
March 2020
*  
*  
*  
*  
*  
*  

Asset and Liability Declaration

If Nil insert 0
As at 28 February 2020
As at 31 March 2020

Assets
Liabilities
Assets
Liabilities

Fixed Assets
*
*
*
*

Property/Buildings
*
*
*
*

Vehicles
*
*
*
*

Equipment/Machinery
*
*
*
*

Computer Equipment
*
*
*
*

Furniture
*
*
*
*
Stock/Inventory
*
*

Cash in Bank
*
*

Bank overdraft
*
*

Accounts receivable
*
*

Accounts payable
*
*

- Bidfood
*
*

- SARS
*
*

- Other
*
*

Total

Net Position




Current and Future Trading and employees

Current and Future Trading
Current Trading


Employees
During Lockdown are your Employees being?


Have you applied for assistance from UIF fund Provide details if yes


Pre March 2020 conditions
Number of seats in Restaurant



Number of beds in Hotel

Average monthly purchases that could have been bought from Bidfood
*

Lockdown
Anticipated losses per month under lockdown
*

Anticipated average monthly purchases from Bidfood under lockdown
*
Social Distancing (Running at 50% capacity)
Anticipated losses under social distancing
*

Anticipated average monthly purchases from Bidfood under Social Distancing
*


Anticipated number of seats available under Social Distancing



If Bidfood ringfences your Outstanding debt, what period would you need to pay the debt off once the lock down has been lifted?
*

Are you intending to apply for any of the following?
Details if yes

In applying for the Bidfood Covid-19 relief initiatives I agree to the below:
That information stated above is true and correct*
I am duly authorised to apply for this relief on behalf of the entity*
I being duly authorised hereby agree to sign an Agreed Payment Plan that binds the Entity for the outstanding debt with Bidfood*
The outstanding debt will be taken weekly on an agreed basis by Bidfood via the Standard Bank debit order facility on the agreed due date*

(By submitting this document you are agreeing to the above conditions)