International Distributor Questionnaire: Company Name

TEL：0411-84288128 84288138
DALIAN PETROLEUM INSTRUMENT CO., LTD. FAX：0411-84288038

TEL：0411-84288128 84288138 FAX：0411-84288038 Email: sales@dsy1988.com.cn
Email: foreign@dsy1988.com.cn WEB：www.dsy1988.com.c WEB：www.dsy1988.com.cn
INTERNATIONAL DISTRIBUTOR
QUESTIONNAIRE
Company Name:
TEL：0411-84288128 84288138
INTERNATIONAL DISTRIBUTOR QUESTIONNAIRE
The following information must be provided in order to be considered as a

distributor of Dalian Petroleum Instrument Co. Ltd. Please provide as much
information as possible.
PLEASE NOTE: THIS QUESTIONNAIRE DOES NOT CONSTITUTE A CONTRACT OR ANY
OFFER FOR DISTRIBUTORSHIP.
I. COMPANY INFORMATION
Company Name:
Street Address: P.O. Box:
City/State/Province:
Postal Code: Country:
Telephone Number: Fax Number:
Company Website:
President/CEO:
Managing Director/General Manager:
Person to Contact: Title:
E-mail Address:
Mobile Number:
Please indicate below, your type of business:
□Manufacturer □Distributor
□Broker/Trading Company □Inspection
Please provide us with your company’s sales (in USD) for the following years:
2011 US $ ______________
TEL：0411-84288128 84288138
2012US $ ______________
2013US $ ______________
2014 US $ ______________
2015 US $ ______________
II. ORGANIZATION
1) What year was your business established?

2) Indicate number of years in Petroleum Tester-related business: _____ years
3) In which countries/countries, beside your own, do you have your branches?
□YES □NO If yes, please list the location of your branches:
__________________________________________
4) Is your company a division or subsidiary of another company? □YES □NO
If yes, please list the name and location of parent company:
__________________________________________
5) How many people does your company employ?
6) How many sales representatives are in your company?
7) How many service engineers are in your company?
8) Do you represent any other petroleum tester manufacturers currently?
□YES □NO If yes, please list the name of the brands or other manufactures:
__________________________________________
9) Which industrial standard for test method is used in your region?
□ASTM □ISO □IP □OTHER ______________
10) Does your company do business with any Chinese company? □YES □NO
If yes, please list the name of the company
__________________________________________
11) Does your company have ISO certification? □YES □NO
If yes, please list ISO number (e.g. ISO 9001)
TEL：0411-84288128 84288138
III. SALES & MARKETING
1) How many sales representatives will be selling our products:

2) How many service engineers will be servicing our products?
3) Will you hire or appoint a marketing manager for our products? □Yes □No
4) Do you know if the below manufacturers are active in your area? □Yes □No
If yes, please rate their market share and their agents or distributors names:
Manufacturers Name Market Share Their agents or distributors name
□ PAC %
□ Anton Paar %
□ Eralytics %
□ Grabner Instruments %
□ Rigo %
□ Tanaka %
□ Stanbope-seta %
□ Koehler Instrument %
□ Normalab %
□ Cannon Instrument %
□ Phase Technology %
□ Other %
*We will very appreciate if you can let us have more details about this issue.
5) What kind of customers do you focus on?
□ Refineries
□ Petroleum Chemical Products Companies
□ Biofuel Companies
□ Power Supply Companies
□ Inspection Companies
□ Other: ____________
6) Will you use any sales representatives or subdealers for our products?□Yes □No
If yes, please list your approximately resale margin ____ %
7) What is the VAT tax rate: ____ %
8) What are Import duties on certain petroleum testers? ____ %
TEL：0411-84288128 84288138
IV. SALES PROJECTIONS
Please complete the table below for sales projections of each product you choose to
distribute in your local market. If you wish to go beyond your local market, contact us
for additional information.
If you need additional space, please use Microsoft Excel to create a larger list.
Sales Projection 1st Year Qty 2nd Year Qty 3rd Year Qty
Open Cup Flash Point Tester sets sets sets
Automatic Open Cup Flash Point Tester sets sets sets
Closed Cup Flash Point Tester sets sets sets
Automatic Closed Cup Flash Point Tester sets sets sets
Distillation Tester sets sets sets
Automatic Distillation Tester sets sets sets
Tester for Hydrocarbon Types sets sets sets
Pour Point Tester sets sets sets
Foaming Characteristics Tester sets sets sets
Micro Carbon Residue Tester sets sets sets
Tester for Corrosiveness to Copper Strip sets sets sets
Kinematic Viscosity Tester sets sets sets
Apparent Viscosity Tester for Engine Oil sets sets sets
Existent Gum Tester sets sets sets
V. REFERENCES
1) BANK REFERENCE
Name of your Bank:
Address:
Telephone: Fax:
2) PAYMENT: Who is responsible for payment?
TEL：0411-84288128 84288138
Name:
Title:
Telephone: Fax:
Email address:
VI. ORDER LOGISTICS
1) Ports to be used: ____________

2) SHIP-TO: Please provide the exact ship-to address for orders
Name:
Address:
Person to Contact:
Telephone:
Fax:
Email Address:
3) Freight-Forwarder:
Please specify if there is a particular freight forwarder that you prefer, use presently
or that you have worked with in the past.
Name:
Address:
Person to Contact:
Telephone: Fax:
Email Address:
4) INSPECTION:
Is inspection (by SGS or other) required before shipment □Yes □No
If yes, please list the inspection company names and their agents in China:
Name:
Address:
Person to Contact:
TEL：0411-84288128 84288138
Telephone:
5) INSURANCE:
Is a Certificate of Insurance required with each shipment? □Yes □No
If yes, please list the insurance company names and their agents in China:
6) DOCUMENT:
Please indicate which documents are required with each shipment
□ Commercial Invoice (How many copies?)
□ Airway Bill
□ Certificate of Origin:
□ Certificate of Test
□ Others:
DATE:
Thank you for taking the time to complete this Questionnaire.

It is important to us to insure that our distributors are knowledgeable of the market,
experienced in sales and marketing, and financially secure to properly support the
process.
Upon reviewing your information, we will contact you as soon as possible. Please do
not hesitate to contact us if you have any questions or comments.
Your interest in our pharmaceuticals products is greatly appreciated.

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TEL：0411-84288128 84288138

DALIAN PETROLEUM INSTRUMENT CO., LTD. FAX：0411-84288038

INTERNATIONAL DISTRIBUTOR QUESTIONNAIRE

The following information must be provided in order to be considered as a

1) What year was your business established?

III. SALES & MARKETING

1) How many sales representatives will be selling our products:

IV. SALES PROJECTIONS

VI. ORDER LOGISTICS

1) Ports to be used: ____________

Thank you for taking the time to complete this Questionnaire.

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