Investor Relations Services
Agreement Form for Inclusion in Mergent Industrial and International Manuals & News Reports
The undersigned company hereby requests Mergent to review the company’s information for listing in Mergent Industrial and International Manuals & News Reports, www.mergent.com and our redistributionship services at the following level of Investor Relations coverage. Standard Manual Exemption Listing Options and Pricing: Manual Exemption Listing Options Initial Regular Listing Processing Fee (Published within 10 business days) Initial Expedited Listing Processing Fee (Published within 3 business days) Annual Renewal Listing Fee
* Prices are effective through December 31, 2006.
Listing Pricing $3,300 $5,000 $950 U.S. Company or $1,200 Non-U.S. Company
Please complete the following application to process your listing. NAME: _______________________________ TITLE: ________________________________ COMPANY NAME: ____________________________________________________________ ADDRESS: ____________________________________________________________________ CITY: __________________________ STATE/PROVINCE: __________________________ POSTAL CODE: ____________________ COUNTRY: _______________________________ TELEPHONE #: _________________________ FAX #: ______________________________ EMAIL ADDRESS: _____________________________________________________________ AUTHORIZED SIGNATURE: ________________________________ DATE: ____________
*Please note that payment is required in advance to process the application. 60 Madison Avenue, 6th Floor New York, NY 10010 Tel: 212-413-7747 Toll-Free: 1-800-433-0877 Fax: 212-413-7670
Investor Relations Services
General Inclusion Guidelines Form for Mergent Industrial and International Manuals & News Reports
Inclusion Requirements: Audited financial statements. If a subsequent merger or acquisition has occurred, a pro-forma reflecting the new or merged entity is also required*. Description of company’s active business & operations (blind pools not accepted) Source documents utilized to formulate & maintain listing o Latest annual report o Final audited prospectus (if IPO) o Press releases (if applicable) o Any other related documents Please complete the following information. Also, please include a description of any acquisitions or divestitures, along with the effective data and terms and a description of current business activities. Number of Employees: ______________________ as of (date) _________________________ Number of Stockholders: ____________________ as of (date) _________________________ Shareholder Relations Contact: ___________________________________________________ Telephone #: ____________________________ Fax #: _______________________________ Website Address: ______________________________________________________________ Incorporation Date: ____________________ State & Country: _________________________ Reincorporation Date: __________________ State & Country: _________________________ List of Company Officer with Title: ____________________________________ ____________________________________ ____________________________________ List of Directors with Title: ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________
60 Madison Avenue, 6th Floor New York, NY 10010 Tel: 212-413-7747 Toll-Free: 1-800-433-0877 Fax: 212-413-7670
Investor Relations Services
Company Listing Information for Mergent Industrial and International Manuals & News Reports
Company Information included in company profile (Please note that Mergent will collect this information): Company Profile Data Items Company Narratives: Company History Business Description Subsidiaries Plants & Property Management Listing Footnotes Financials: Income Accounts Balance Sheets Capital Stock
* Brief is defined as basic coverage (i.e. hundred words or less in business description).
Listing Coverage Brief Brief Brief Brief Brief If available 3 Years 2 Years Brief
Additional Company Profile Data Items (if available) Address, Telephone, Fax and Email Number of Stockholders Co. Website (live link from mergent.com) Transfer Agent Annual Meeting Date Shareholder Relation Contact Counsel 5-year Stock Pricing Range Auditors Number of Employees Long-Term Debt
60 Madison Avenue, 6th Floor New York, NY 10010 Tel: 212-413-7747 Toll-Free: 1-800-433-0877 Fax: 212-413-7670
Investor Relations Services
*Acquisitions/Mergers Please submit all documentation of any merger and/or acquisition. The following data points are an integral step for presentation to Mergent’s Editorial Review Board, and ultimately the approval of your company’s listing in Mergent’s Manuals and News Reports: (a) Date of the consummation of the Merger/Acquisition. (b) Entities involved in the transaction [name of acquired or merged company or companies.] (c) Terms and conditions of the transaction. If there is a Reverse Merger or Acquisition, the following information is also needed: (a) Date of the consummation of the Reverse Merger/Acquisition. (b) Entities involved in the transaction [name of acquired or merged company or companies.] (c) Terms and conditions of the transaction. (d) Audited financials for the company or companies in the transaction. Pro-forma financials for the company along with the financials of the companies or company in the Reverse Acquisition/Merger with the pro-forma adjustments and pro-forma combined statement for all accounts and columns clearly identified.
60 Madison Avenue, 6th Floor New York, NY 10010 Tel: 212-413-7747 Toll-Free: 1-800-433-0877 Fax: 212-413-7670