Dear customer,

We thank you for your interest in our Xsense web based cold chain monitoring and
reporting system.

To help us serve you best, we ask that you fill in the below questionnaire. Please be as
specific as you can with your inputs as they will determine the preferred solution and service
program that may best suit your needs.

Customer Questionnaire
Please check (click) √ the appropriate boxes, type your responses in the adjacent space,
or select a response by clicking on the drop-down Select option.
Press the Tab key to move through the questionnaire.
Remember to save the document.

I. General Information

Company name

Ship to Address (Include Zip code)

VAT Number

Company phone #

Fax

Main Contact Name

Main Contact Email

Main Contact Mobile #

Billing Contact Name

Billing Contact Email

Billing Contact Mobile #

Contact Name for Technical Support

Contact e-mail for Technical Support

Contact Mobile No. for Technical Support

TEL. +972 (0)4 9122800 | FAX. +972 (0)4 9122801 | 33 Dolev St. | P.O.B. 54, Migdal Tefen, 2495900 Israel
 II. Perishables Information

(Select one or more), please specify the product varieties

Fresh produce
Products:
Fresh cuts produce
Bakeries
Meat
Fish / Seafood
Dairy
Pharmaceutical
Other (please specify)

Product varieties: ______________________________________________

Country / region of produce growing / product mfg. or processing

Harvest / Production season

Annual volume produced

Annual volume of shipments

Annual volume of pallets/boxes

III. Marketing Information

What is the intended market for your produce?

Annual No. Of Countries of Destination

Pallets

Export

Import

Domestic

IV. Seasonal Operation

TEL. +972 (0)4 9122800 | FAX. +972 (0)4 9122801 | 33 Dolev St. | P.O.B. 54, Migdal Tefen, 2495900 Israel
 All year around operation
Seasonal operation:
Please specify months of operation:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec

V. Statement of Intent (not legally binding):

Our company is interested in:

(Select one or more)

Monitoring No. of Shipments/Year.

Monitoring No. of Pallets or Boxes/Year.

Monitoring No. of Sites online (real-time).

Monitoring No. of Trucks online (real-time).

Other (please specify)

VI. Shipping destination to:

Countries:

Companies:

TEL. +972 (0)4 9122800 | FAX. +972 (0)4 9122801 | 33 Dolev St. | P.O.B. 54, Migdal Tefen, 2495900 Israel
 Limitation of Liability

BT9 does not warrant that the Xsense System operation will be uninterrupted or error free, or that any
defect within the System will be corrected. Such interruptions and/or errors and/or defects may include,
inter alia, any of the following: (i) Loss of communication between Xsensers and CUs due to attenuation
of signal or any other reason; (ii) Faulty Xsensers that are not recording; (iii) Faulty Xsensers that are
not transmitting data or are transmitting incomplete data; (iv) Power failure of CUs; (v) Loss of cellular
communication for prolonged periods; or (vi) Hosting Server fault. Furthermore, BT9 does not warrant
nor make any representation regarding the results of its customer's use or omission to use (i) the
System, (ii) any of its Components, (iii) the real time alerts, or (iv) information or data provided by the
System in terms of correctness, accuracy, completeness, timeliness of the content, reliability or
otherwise. Use of the System is at the customer’s sole risk. In no event will BT9 be liable for any
indirect, incidental, special, or consequential damages arising out of or relating in any way to the System
and the use thereof (including, without limitation, damages to products, damages for lost information,
lost savings, lost profits or business interruption), even if BT9 has been informed, is aware, or should be
or has been aware, of the possibility of such damages. In no event will BT9 be liable for direct damages
or otherwise in excess of the sums actually paid by the customer with respect to the applicable Order.
Without limiting from the generality of the foregoing, in no event shall BT9 be liable for the customer’s
costs of procuring substitute products or components. For the avoidance of any doubt, the customer
shall be solely responsible for analyzing and using the data provided by the System. BT9 shall not be
liable with respect to the use made of such data.

TEL. +972 (0)4 9122800 | FAX. +972 (0)4 9122801 | 33 Dolev St. | P.O.B. 54, Migdal Tefen, 2495900 Israel