MAIN CONTRACTORS Questionnaire

it´s important you fill in the questionnaire in all its parts, otherwise your request cannot be taken into consideration



Company Name
Contact person
Managing Director(s)
Address
Country
Year your company was established
 Phone
Fax
E-mail
Web site
VAT Number (only for UE countries)
Total N. of employees
N. of Salesmen
N. of Technicians

Is your company a division or subsidiary of a Group? (if YES, please state)



Which SIARE products are you interested in including in your package of habitual suppliers?

Anaesthesia machines
ICU Ventilators
Turbine Ventilators
First-Aid Emergency ventilators
Monitoring Systems
 Electronic Humidifiers
Technical Bed-head and Pendant Units
Surgical Aspirators
All products


In which countries do you work mainly? Please state


Through which international organizations? (ex. UNFPA, WORLD BANK, WHO, etc. Please state:


Do you have local agents in the countries you mentioned? If YES, please State:


Do you have a technical team for the installation of the equipment on-site?


Are you able to provide technical support on-site?


Have you already bought similar products of ours before? If Yes, please state from which company/ies?


Please indicate your annual turnover in EUR


Please indicate the most important supply effected this year /EUR


Banking data



Privacy policy
In accordance with the Italian Privacy Law Nr. 196/03, all your personal data and information will be entered into our database and strictly used and processed for our corporate business activities. In accordance with the Article 7 of the a.m. law, thirds may request to change or cancel their data from our database at any time by simply notifying mail@siare.it.