Custom Database Quote Request

This quote requested by:
Name: Job Title:
Phone Number: Email:

Company Name:

Who makes the final decision on this quote?
Name: Job Title:

Industry Specification (check all that apply)
Pipeline Refining Gas Processing
Petrochemical Drilling Well Servicing
Liquid Terminals Electric Utility Gas Utility
Underground Natural Gas Storage

Exploration and Production
Offshore International (Outside US & Canada)

Geographic Target Regions (Required)
Worldwide US Canada Other

Specific Countries or States:

Company Information Needed
Name Physical Address Mailing Address
General Phone General Fax General Email
Website Financials None

Specific Type of Company Information Requested:

Maximum number of companies:
Maximum number of contacts:

Include facilities/offices which do not have contacts.
Include contacts which do not have email addresses.

Include company financials?
Use of information
Bulk Email Physical Mailing Database

What is your target date for mailing?

How will you follow-up on leads?
Phone Email Mail In Person

Facility Categories
Plants Headquarters Field Offices
Refineries Terminals Business Offices
(Pipeline Only)
Pump Stations Compressor Stations

Individual Contact Information Needed
Name Title Direct Email
Direct Phone Direct Fax Cell

Titles of Contacts to Include
Chairman CEO President
Controller Landman GM
Bus Devel Marketing Sales
Maintenance Operations IT
Foreman Engineer Geologist
Health Environmental Safety
HR Office Support Quality
Purchasing Financial Administration

Dept Director Manager Supervisor

Specific Target Contacts

Service & Product Suppliers

Include Engineers Contractors and Service Companies?

Include Equipment Manufacturers and Suppliers?

Include Trade Associations and Regulatory Agencies?

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