MASTER / SUB DISTRIBUTOR BUSINESS PROFILE FORM COMPANY INFORMATION Company Name: Main Contact: Address: City: State: Zip: E-mail address*: *Needed to comply with tracking requirements Web Site URL (if available): Signatory Name: Signatory Job Title: Phone: Fax : Resale certificate #: COMPANY PROFILE How long has your company sold medical equipment? Has your company previously sold or does your company currently sell defibrillators? Does your company offer training solutions? What other product lines does your company currently sell? COMPANY PROFILE (cont'd.) What are your company's target markets? (vertical markets) Into what geographic areas does your company sell? Who are your company's major competitors? How do you market your company and the products you represent? How would you incorporate Philips in your company's marketing efforts? Does your company currently forecast unit volume? Would you be willing to provide unit volume forecasts to Philips? Additional comments:
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