Business Alliance Application

Contact Info

Company Name:
Contact Name:
How long in Business:
Mailing Address:
Contact City:
Contact State:

(applicable to U.S. & Canada; otherwise can leave blank)
Contact Zip Code:
Contact Country:
Contact Phone:
Contact Fax:
Contact Email:
Web Site:

 


Company Info
Company Mission:
Number of Full-time Employees:
Annual Revenue:
Number of Sales Staff:
Number of Service Staff:
Existing Reseller Agreements?
Yes
No
If yes, please list:
Please describe your company's Ultrasound expertise:

 


Business Alliance Program Choices
(see below for descriptions)



OEM ( 1.1 )
Distribution Integrator ( 1.2 )
Reseller, Agent, Manufacturers Representative ( 1.3 )

1.1

The Imperium OEM relationship is for companies that wish to license the Imperium Ultrasound technology and embed it into their product. The OEM relationship requires the Business Partner to make royalty payments, maintain sales minimums and provide installation and support.
1.2
The Imperium Distribution Integrator relationship is for companies who have the ability to sell, design, build, install and support customized Ultrasonic Inspection Systems. The Distribution Integrator relationship allows for product discounts based on sales. Imperium provides the Distribution Integrator with training and second tier support. The Distribution Integrator is responsible for all end-user customer sales, support and billing.

1.3 The Imperium Reseller relationship is for companies seeking to distribute the Imperium Ultrasound technology on a commission basis. There are different levels of reseller based on commitments such as sales and training.

 


Customer References
Customer Name:
Describe Customer Business:
 
Contact Name
Title
Phone

 


Tradeshow Information
 
Please list your Trade Show Schedule for the next twelve months where your company will have a booth, include Trade Show name, date, and location:


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