JITSA IT Business Registry Submission Form NOTE: The “Accuracy of Information, Indemnity & Due Diligence” Clause at the end of this form MUST be agreed and accepted by the company’s Authorised Representative ONLY, before the form is submitted. 1 Start 2 Preview 3 Complete 0% Company Information Company Name * Company Logo * Files must be less than 2 MB.Allowed file types: gif jpg png. Company Structure * Sole Proprietorship General Partnership Limited Liability Multi-National Corporation Joint Venture Other (Please identify) Company Structure (other) Company Description Company Description in 250 words or less Address Street Address 1 * Street Address 2 City * Postal Code Presence * Local English Speaking Caribbean Spanish Speaking Caribbean French Speaking Caribbean Central America Latin America North America Other (Please identify) Presence (other) Contact Primary Contact Name * Primary Contact Phone * Secondary Contact Name Secondary Contact Phone Website URL * Facebook URL Twitter URL Business Focus IT Business Focus/Vertical * IT Products and Service Providers Software Developers IT Consulting Services Telecommunications Providers Business Process Outsourcing (BPOs) Independent Consultants/IT Professionals Other (Please indicate) Business Focus (other) Services Category of Services * Hardware Software Installation Design & Configuration Training Software Development Project Management Roll Out_Implementation Services Assessment Services Acceptance Testing Process Re-engineering Maintenance & Support Services Change Management Integration Services Cloud/Hosted Services Other (Please Specify) Category of Services (other) Additional Company Information COJ Registration Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031 Years in Operation Number of Branches/Offices Number of Employees * Company Revenue ($JMD) * Less than $50m $50m - $100m $101m - $250m $251m - $500m Over $500m Company Certifications PMI CMMI ISO Microsoft Cisco CISSP Vendor Specific Certifications Vendor Specific Certifications (other) Major Projects Completed Please list 3 projects. Information limited to 250 words. Accuracy of Information & Due Diligence Clause * This is to certify that the information provided above is True and Correct to the best of my knowledge at the time of submission. Should any information provided be found to be incorrect, false and/or inaccurate, we understand that this may result in our company being de-listed from JITSA's IT Business Register; this in an effort to ensure that JITSA maintains the highest level of accuracy and integrity in the content of their Directory. We indemnify JITSA from any errors, inaccuracies, omissions and the like and place the full responsibility for information provided herein on the company's authorised representative. We further indemnify JITSA for any/all inquiries, leads, opportunities, business and the like, which may be forwarded or follow, recognising and acknowledging that it is the full responsibility of our organisation to conduct the appropriate and proper due diligence. We understand that the purpose of this IT Business Register is to share and make available any of the information provided herein, in whole or in part, to JITSA's members, key industry stakeholders and business prospects and understand that JITSA cannot be held responsible and/or accountable should any information provided be released and/or made available by any unauthorised means and/or to any 3rd parties without JITSA's prior consent." b. The above “Accuracy of Information, Indemnity & Due Diligence” Clause MUST be agreed and accepted by the company’s Authorised Representative ONLY.