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This application form should be used for production material suppliers only. Please do not submit for MRO or other services.

General Information

*Company Name:

*Address:

*City:

*State/Province:

Zip Code:

*Country:

Parent Company Name:

*Primary Contact Name:

*Phone:

Fax:

*E-mail Address:

Website:

*Company Ownership:

*Type of Business:

*Years in Business:

*Annual Sales :

*Number of Salaried Employees:

*Number of Hourly Employees:

*Primary Currency:

Additional Currencies:

*Warranty Coverage:

Public Liability Coverage :

Top Three Customers

Customer Name :

Percentage of Business Revenue (%) :

Customer Name :

Percentage of Business Revenue (%):

Customer Name :

Percentage of Business Revenue (%):

Production Facility Location (That will supply to Hendrickson)

*Address:

*City:

*State/Province:

*Zip Code:

*Country:

*Shipping/Receiving Department Hours of Operation:

Capacity Utilized (%):

*Labor Union (Affiliation, Local Number, Contract Expiration Date):

Geographic Locations

North America:

ServingAble to ServeNot Able to Serve

North America Years of Service:

South America:

ServingAble to ServeNot Able to Serve

South America Years of Service:

Europe:

ServingAble to ServeNot Able to Serve

Europe Years of Service:

Asia Pacific:

ServingAble to ServeNot Able to Serve

Asia Pacific Years of Service:

Product Categories

Product Categories:

Air ControlsAir SpringsAluminum PolishAluminum SheetAxlesBearingsBlanks - LaserBrake AssembliesBrake ChambersBushings - MetalCastings - ADICastings - AluminumCastings - DuctileCastings - SteelClad MaterialCoil SpringsDrumsElastomersFabricationsHardware - Bolts, Nuts, WashersHeight Control ValvesHubsHub CapsHub/Drum AssembliesForgingsLubricantsMachiningPaint ProcessorPaint - Raw MaterialsPlastic PartsPlatingPlating - ChromeSealsShock AbsorbersSlack AdjustersSpring SteelStampingsSteel - BarSteel - SheetSteel - TubingSteel SpringsTie RodsU-BoltsOther (Specify Below)

Other Product Categories (specify):

Quality and Delivery

Certification:

Expiration Date :

Certification:

Expiration Date :

Certification :

Expiration Date :

Certification :

Expiration Date :

Certification:

Expiration Date :

*On-Time Delivery to Customers (12-Month Average %):

*Non-Conforming PPM to Customers (12-Month Average):

Oceania

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