Distributor Inquiry & Qualification Questionnaire

Distributor Inquiry & Qualification Questionnaire
Issued by CSS Technology, LLC | Manufacturer of ROADBOND EN 1
Thank you for your interest in representing ROADBOND EN 1. This questionnaire is the first step in evaluating prospective distributors. Complete responses help us match qualified partners with viable territories, confirm operational and regulatory readiness, and ensure customers in your market are served by a representative who can deliver on the performance ROADBOND EN 1 is known for.

CSS Technology, LLC is the manufacturer of ROADBOND EN 1. Authentic product is available through roadbondsoil.com and through distributors authorized in writing by CSS Technology, LLC. Other products marketed under similar names are not affiliated with CSS Technology, LLC.
Instructions
- Complete every field. Mark items that do not apply as "N/A"
- Type directly into this document, or print and complete by hand.
- Submit completed form to info@roadbondsoil.com, or by mail to P.O. Box 549, Tolar, TX 76476.
- Information you provide is treated as confidential and used solely to evaluate your inquiry.
SECTION 1 APPLICANT COMPANY
Legal company name
DBA / trade name (if any)
Year established
Entity type (LLC, Corp., LP, Sole Proprietor, etc.)
State / Province / Country of formation
Federal Tax ID / EIN (or international equivalent)
Primary business address
Mailing address (if different)
Website
Main phone
Format: (000) 000-0000.

Name up to five key relationships you believe will support adoption of ROADBOND EN 1 (organization, person, role, length of relationship). Do not list contact details for these individuals here.
SECTION 8 SALES & MARKETING CAPABILITY
Outside sales staff (# FTE)
Inside sales staff (# FTE)
Technical sales / engineering staff
Marketing staff
Primary sales channels (check all):
Outline how you would introduce and promote ROADBOND EN 1 in your territory during the first 12 months.

SECTION 9 TECHNICAL & FIELD SUPPORT CAPACITY
Mark all that apply:
Identify any engineering, lab, or contractor partners you would lean on for technical credibility in your territory.
SECTION 10 FINANCIAL & REFERENCES
Willing to provide on request:
Primary banking institution
Bank contact name and phone
Three trade references (company, contact, phone, email, nature of business with you).

SECTION 11 BUSINESS CONDUCT & BRAND INTEGRITY
Acknowledge each (check):
Disclose any pending or past litigation, regulatory action, or bankruptcy involving your company or its principals within the last seven (7) years. If none, write "None."
Disclose any potential conflicts of interest, including competing soil-stabilizer lines you currently or recently represented.
SECTION 12 GOALS & FIT
Why do you want to distribute ROADBOND EN 1?

How does ROADBOND EN 1 fit into your existing portfolio and customer base?
Projected sales volume in your proposed territory (gallons or dollars):
Year 1 projection
Year 2 projection
Year 3 projection
Initial inventory commitment
SECTION 13 ACKNOWLEDGMENT & SIGNATURE
By signing below, the undersigned represents that:
- All information provided in this questionnaire is true and complete to the best of their knowledge.
- They are authorized to submit this inquiry on behalf of the applicant company.
- CSS Technology, LLC may verify any information provided, including by contacting references.
- Submission of this questionnaire does not create a distributor relationship or any contractual obligation. A written agreement signed by an authorized officer of CSS Technology, LLC is required before any distributor relationship is established.
Signature
Printed name
Title
Date

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Date
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