WYNN RESORTS (MACAU) S.A.

Vendor Registration Form

1 Company Name 2 Tax ID Number
3 Contact Person (Full 4 Title
Name as appear on
passport or ID Card)
5 Phone Number 6 E-Mail Address

7 Account Executive/Sales Manager Details 8 Accounting Contact Details

Name Name
Title Title
Phone Number Phone Number
Fax Number Fax Number
Email Address Email Address

9 Address of Company Head Quarters 10 Address of Local Office

Street Address 1 Street Address 1
Street Address 2 Street Address 2
City City
State / Province State / Province
Postal Code Postal Code
Country Country
Phone Number Phone Number
Fax Number Fax Number

11 Remittance Address 12 Factory Address

Street Address 1 Street Address 1
Street Address 2 Street Address 2
City City
State / Province State / Province
Postal Code Postal Code
Country Country
Phone Number Phone Number
Fax Number Fax Number

13 Date and Place

company was formed:

14 What type of organization is the Company?

Please Check the Appropriate box.

Public Limited Liability Company / Corporation

Name of Stock Exchange Market and Trading Symbol:

Private Limited Liability Company / Corporation

General Partnership

Sole Proprietorship

Limited Liability Corporation

15 Number of Employees

16 List all Professional Licenses held by Company

Organization Issue Date / Expiration Date
Organization Issue Date / Expiration Date
Organization Issue Date / Expiration Date

17 Is the company going to provide products or services to Wynn Resorts (Macau) S.A?

Product Service Both

18 What type of products or services is the company providing? Please provide your company background for reference.

19 Are you currently a Supplier/Vendor for, or in any business relationship with, any Casino in Macau/Worldwide?

No

Yes; Please specify below

20 Related Third Party?

Is anyone in your company related to a Wynn Resorts (Macau) S.A. employee? If so please state the name and relationship.
Name Relationship W ynn Resorts (Macau) S.A. Employee

Page 1 of 2
21 Please list the key agents of the Vendor (Domestic China and International)
(Key Agent: Any director, officer, principal, partner, owner or manager with authority to formulate, direct or execute company policy)

Name (Last, First, Passport or ID # and Macau Resident

Middle) (As appeared on Title SS# (If US Citizen or (Y/N) % of Shares Held
passport or ID Card) resident alien)

22 Please list all affiliated companies with the Vendor.

Company Name Nature of Affiliation Address

23 Please list all trade names under which the vendor has conducted business.

CRYSTAL FOUNTAINS INC

24 Have any criminal actions or civil lawsuits, other legal proceedings or bankruptcy proceedings been instigated against the vendor
or its key agents in the last ten year (10) years? Please tick appropriate response.

No

Yes; Please explain below

25 Please list your 5 largest clients / Projects in the last five years.
1
2
3
4
5

26 Please list all major manufacturers, suppliers, and sub-contractors that the vendor plans to use at Wynn Resorts (Macau) S.A. if selected as a vendor.

1 APS METALS INDUSTRIES

2 STANDARD BRASS
3 MICROART SERVICES
4 FASTENAL CANADA
5 COOK FASTENERS

27 The following documents must be attached. Indicate the documents provided by checking the box.
1 Current Business Registration or Certificate of Good Standing

2 M1 and M8 (for local Macau vendors)

28 PLEASE NOTE THAT WYNN RESORTS (MACAU) S.A. STANDARD PAYMENT TERMS ARE NET THIRTY (30) DAYS.

29 Company stamp and Date

Company stamp and authorized signatory Date

An authorized representative of the company must certify by signing here that to the best of his/her knowledge that all information provided above
is correct and accurate. Your application will not be processed until a complete vendor registration form is received.

For Internal Use Only

WRM Purchasing WRM Corporate Investigation
Date to Corporate Investigation
Approved by :
Date from Corporation Investigation
Nothing Adverse Rejected

Authorized by

Page 2 of 2