F-720-002

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May 11, 2016

NEW CUSTOMER INQUIRY FORM

Thank you for your interest in the CTP new replacement parts for Caterpillar application. To further
expedite the creation of your account, please provide the following data, so I could create your account.

Company Name: carlos tovar Address: psj balconcillo b-1

City: arequipa State: arequipa

Zip code: 51 Country: peru

Telephone Number: 963385306 Contact Name:

E-mail: carlos.cts20@gmail.com Website:

Spoke to a Costex Salesperson?

If so please specify name: roberto rrivera

How did you hear about us?

Trade Show Auction
Please specify location and date (mm/yy): Please specify location and date (mm/yy):
arequipa-peru 09/2017

Magazine Referral
Please specify magazine name: Please specify referral:
ctp

Search engine Other

Google Please specify:
Other:

Direct Mail (Brochure, letter, postcard, etc.)

A brief description of your activity:

Reseller Export
Region and/or states: Specify country and/or continent:
arequipa -peru

Other Repair Facilities

Please specify:

Where do you currently buy your CAT Replacement parts ? ferreyros cat

What heavy equipment brands do you buy parts for? cat

Please list the % of machine population in your market:

CAT: 90 % KOMATSU: 70 % J.DEERE: 30 % VOLVO: 80 % CASE: 50 %

SUBMIT
MIAMI HEADQUATERS: 6100 NW 77TH CT, MIAMI, FL 33166 PHONE: 305-592-9769 FAX: 305-592-7355
DALLAS BRANCH: 1441 S. BELTLINE RD. COPPELL, TX 75019 PHONE: 214-231-7455 FAX: 214-231-7457
Cat and Caterpillar are registered trademarks of Caterpillar, Inc.