SurveyMonkey Powered Online Survey

By registering your interest in this database, you are agreeing to comply with Incitec Pivot Limited (IPL) purchasing principles and purchase order (PO) conditions, both of which may change over time. For more information on the PO conditions follow this link.

Question Title

Business Information
* Denotes mandatory field

*Business Name

*Street Address

*City

*State

*Post Code

*Country

*ABN/ACN/Business Registration Number

Question Title

*Is your business registered for GST?

Yes

Question Title

*Has your business supplied goods or services to IPL in the past 12 months?

Yes

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*Are you an Indigenous business - (at least 50% owned, managed and controlled by Indigenous people)?

Yes

Question Title

Website Address

Question Title

Contact Information

*Contact Name

*Contact Job Title

*Contact Phone

*Contact Email

Question Title

E-procurement Capability

Currently can invoice customers electronically

Currently can receive purchase orders electronically

Can provide e-catalogues

None of the above

Question Title

About Your Business
*Select the primary category that best describes your business

Question Title

Select any additional categories of goods or services which you supply.
Categories help IPL identify interested suppliers for market opportunities.

	Please select an option
Category 2	Category 2 Please select an option menu
Category 3	Category 3 Please select an option menu
Category 4	Category 4 Please select an option menu

Question Title

*Briefly describe your core business

Question Title

Location
*Please tick which areas you are able to service within each state
QLD

QLD (all areas)

Bajool

Blackwater

Bowen Basin

Bundaberg

Cairns

Cloncurry

Dysart

Emerald

Gibson Island

Helidon

Mackay

Moranbah

Moura

Mt Isa

Phosphate Hill

Pittsworth

Townsville

Question Title

NSW

NSW (all areas)

Boggabilla

Griffith

Gunnedah

Kooragang Island

Moree

Mt Thorley

Newcastle

Orange

Warkworth

Wee Waa

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SA

SA (all areas)

Port Adelaide

Port Lincoln

Port Pirie

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NT

NT (all areas)

McArthur River

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WA

WA (all areas)

Collie

Kalgoorlie

Laverton

Newman

Nifty

Perth

Port Hedland

South Hedland

Telfer

Wiluna

Woodie Woodie

Yarrie

Question Title

VIC

VIC (all areas)

Geelong

Portland

Southbank

Question Title

TAS

TAS (all areas)

Devonport

Question Title

Insurances
Please indicate the following levels of cover you have

Contractor Work Insurances

Professional Indemnity

Public and Products Liability

Workcover

Question Title

Business Information* Denotes mandatory field

Question Title

*Is your business registered for GST?

Question Title

*Has your business supplied goods or services to IPL in the past 12 months?

Question Title

*Are you an Indigenous business - (at least 50% owned, managed and controlled by Indigenous people)?

Question Title

Website Address

Question Title

Contact Information

Question Title

E-procurement Capability

Question Title

About Your Business*Select the primary category that best describes your business

Question Title

Select any additional categories of goods or services which you supply.Categories help IPL identify interested suppliers for market opportunities.

Question Title

*Briefly describe your core business

Question Title

Location*Please tick which areas you are able to service within each stateQLD

Question Title

NSW

Question Title

SA

Question Title

NT

Question Title

WA

Question Title

VIC

Question Title

TAS

Question Title

InsurancesPlease indicate the following levels of cover you have

Business Information
* Denotes mandatory field

About Your Business
*Select the primary category that best describes your business

Select any additional categories of goods or services which you supply.
Categories help IPL identify interested suppliers for market opportunities.

Location
*Please tick which areas you are able to service within each state
QLD

Insurances
Please indicate the following levels of cover you have