All Information Furnished Shall Be Considered Confidential
Company Name
Street
City, State, Zip Code
Phone, Fax
Customer Service - Name, Phone
Sales Contact - Name, Phone
Off-Hour Emergency - Name, Phone
Federal Tax I.D. #
Dun & Bradstreet #
Internet Address
Payment Terms
Delivery Terms
1. What products/material does your company sell/distribute?
3. What type of value-added services would your company offer:
4. References:
Company:
Contact:
Phone:
Company:
Contact:
Phone:
Company
Contact
Phone:
5. Person Completing Questionnaire:
Name
Title, Date
6. Please Return To:
Central Hudson Gas & Electric Corporation
ATTN: Purchasing Department
284 South Avenue
Poughkeepsie, NY 12601-4879
Please include with your reply, your product line-card and anything else you wish to be considered in your evaluation. Thank you for taking the time to fill out this questionnaire.
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