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Account Number
*look on your mailing label
Name
Organization
Address
City
State
Zip
Country
Phone
Fax
Email
1. Which best describes your company's primary business?
(check one)
Delivery/Courier Service
Construction
Natural gas Conversion Systems/Components
Retail Trade
Wholesale Trade
Natural gas Fueling Stations /Components
Manufacturing
Finance/Insurance /Legal
Natural gas Conversion Systems & Fueling Stations
Communications
Agriculture/Forestry/Fishing
Research & Development
School/College /University
Natural gas and/or Gasoline Retailer
Consulting/Training
Food Products
Natural gas Fuel Supplier /Marketer
Industry Association
Government
Automobile Manufacturer/Dealer
Gas and/or Electric Utility
Hospitality
Large Vehicle Manufacturer/Dealer
Other:
Healthcare
Engine Manufacturer /Distributor
Transportation
Natural gas Conversion /Installation/Maintenance
2. Which best describes your job function?
(check one)
Company Official
Engineering/Product Development
Fleet Managment
Service/Maintenance
Marketing & Sales
Administration
Other
3. How many fleet vehicles does your company own or operate?
(check one)
0 vehicles
51-100 vehicles
1-20 vehicles
101-200 vehicles
21-50 vehicles
201 + vehicles
4. Indicate your purchasing authority?
(check all that apply)
Purchase
Recommend
Authorize
None of the Above
Specify
All of the Above
5. Do you plan to purchase, authorize, specify, recommend any natural gas products/services in the next:
3 months or less
Year or more
4-6 months
No spending planned
7-11 months
6. How much do you plan to allocate for any natural gas products/services mentioned in question 5? ($U.S.)
$500,000 or more
$50,000 - $99,999
$250,000 - $499,999
$25,000 - $49,000
$100,000 - $249,999
$24,999 or less
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