Supplier Registration Information

Required fields are bold.

Section I. Business Information

Company Information
Legal Company Name:  
Physical Address:  
Address (Cont.):
City:  
State / Region:
Zip / Postal Code:
Country:
Mailing Address:
Address (Cont.):
City:
State / Region:
Zip / Postal Code:
Country:
Company Phone Number:    Ext.
Company Fax Number:
Company Website (URL):

Principal Owner Information
Name Title E-mail Gender Owner Ethnicity % Ownership

Contact's Information
Contact Name:  
Title:  
Phone Number:    Ext.
Fax Number:
E-Mail Address:
[This will be your login id] 		  

Section II. Business Biography

Company Data
Business Type:  
Legal Structure:  
Geographical Service Area:
Federal ID Number:   (SSN if Sole Proprietorship)
Year Business was Established:  
Number of Employees:  
DUN and Bradstreet Number:  
Primary SIC Code(s):    

Products and/or Services
Select NAICS Code(s) 
To remove items from the list above, highlight the NAICS code and click Remove From List button.
Enter specific keywords describing your business specialty (up to 500 characters)
Are you a current supplier to Schlumberger?
If yes, what Schlumberger Business Unit(s) are you working with? CTRL-click to select multiple options
Annual Sales to Schlumberger:
Schlumberger Contact Name:
Phone Number:   Ext.

Annual Sales Volume
Please include data for the past 3 years. Numbers only, no comma or decimal point (e.g., 3000000).
 

References
List five current business customers (local or otherwise) which have been or are now your customers:
Company Name Contact Name Phone Number

Section III. Business Certification

Certification
Is your business presently certified as a MWBE with the National Minority Supplier Development Council (or local affiliate), Women's Business Enterprise National Council (or local affiliate), National Women's Business Owners Corporation or government agency?
    
If no, skip to the next section.
If your company is certified as MWBE, please list the certifying agency, and upload or fax a copy of your certification to Schlumberger Supplier Diversity at 281-754-4103. The uploaded information must be in a .jpg or .gif file format.
Certification Type (1):  
Certifying Agency:  
Certification Number:
Expiration Date:   (MM/DD/YYYY)  
Upload Certificate
 
Certification Type (2):
Certifying Agency:
Certification Number:
Expiration Date:   (MM/DD/YYYY)
Upload Certificate
 
Certification Type (3):
Certifying Agency:
Certification Number:
Expiration Date:   (MM/DD/YYYY)
Upload Certificate

Safety and Insurance Information
When contract mandates, can your company provide the following safety and insurance information?
Year 1Year 2Year 3
OSHA Total Recordable Incident Rate (TRIR) for the past three years
Number of lost work day cases
OSHA number of recordable incidents
Total number man hours for previous year
Workers compensation experience modification rate (EMR) for the three most recent years.

Company Insurance
Select all that apply. Please format dates as: MM/DD/YYYY
 InsuranceLimitProviderExpiration Date
Automobile Liability
Commercial General Liability
Employer's Liability
Employment Practices Liability
Errors and Omissions
Worker's Compensation

Section IV. Business Type
Is your company Minority Owned?
If your company is Minority Owned please define.
Is your company a Women-Owned Business Enterprise?
Is your company a Small Business?
If your company is Small Business please define.



Is your company a Large Business Enterprise (LBE)?
If yes, do you have a Supplier Diversity Program?
If yes, please provide Manager contact information.
Name:
Phone:
Email Address:
Is your company publicly traded?

Section V. e-Business Readiness
Do you have an online catalog? Can you sell your products/services online?


Are you Electronic Data Interchange (EDI) capable? Do you accept credit cards?


 
By choosing to submit this form, you certify that the information you have provided above is true and accurate.