PROPOSAL DATA SHEET

For a proposal at no cost or obligation, complete the following information, print out and Fax to 804-598-9556. Where costs are requested, please express in US dollars. For data requested that does not apply to your operation, enter NA in the space provided. You should receive a reply by E-mail, Fax or post within 5 to 10 working days of receipt by us. Do not use these data sheets for Military Equipment or Manufacturing Equipment; instead contact us by E-mail or Fax and we will advise the information needed.

1) Name:

2) Organization:

3) Postal Address:

4) E-mail address:

5) Type and number of units operated:

Trucks, Heavy Duty:

Trucks, Medium Duty:

Bus (Transit) Units:

Heavy Earth Moving/Construction:

Autos/Light Trucks:

Marine Engines (specify type vessels):

Other(please specify):

6) Type of organization you operate (check all that apply): General Freight Heavy Construction Public Utility Government (please specify) National State Local

7) Do you currently utilize a “used oil analysis” program in your preventive maintenance procedures? yes no

If “yes”, how far back in time do your records go for each unit (specify years and/or months):

8) How often (specify miles, km or hours) do you remove an oil sample for testing? If more than one interval, so indicate:

9) What is the frequency (specify miles, km or hours) of oil changes (including filters) per unit in your equipment? If more than one frequency, break down as follows:
Nr. Units: @

NR Units: @

10) What is the average fluid capacity of the crankcase or sump of each unit of your equipment? Please express in US quarts on an average basis (total for all units divided by number of units):

11) What is the average fluid capacity of the differentials, gear boxes, manual transmissions, trailer hubs, etc. for your equipment? Please express in US pints on an average basis (total of all units divided by number of units):

12) What is the average fluid capacity of all hydraulic systems you operate which call for an approximate SAE 10 weight hydraulic oil? Please express in US gallons, quarts or pints on an average basis (total for all units divided by number of units):

13) Please provide the following fuel/lube oil bulk tank information. Please state in US gallons:
Number of fuel bulk tanks: Capacity for all

Number of lube oil bulk tanks: Capacity for all

14) The total number of miles, km or hours operated by your equipment for the last 12 months

15) The total US gallons of fuel (all types) consumed in the last 12 months:

16) Your current cost per gallon of fuel (please express in US dollars)? $
(If you use both diesel and gas [petrol], give an average cost)$

17) What is your average miles, km or hours per US gallon of fuel consumed?
Diesel Units

Gas (Petrol) Units

Other (specify)

18) How often in miles, km or hours do you perform an engine rebuild on your units?
Diesel Units

Gas (Petrol) Units

Other (specify)

19) Please give the best estimate possible on the percentage of operating speed of your units as follows:
Highway (55 MPH/88 KM/H or above): %

Urban (30 MPH/48 KM/H or less): %

Suburban (mixed highway and urban speed):%
NOTE: The total of all 3 must equal 100%.

20) Are you currently using any type of synthetic lubricant or fuel or lubricant additive in your equipment yes no

If “yes”, please specify type used and where used by brand name

21) Do you keep very accurate records as to oil consumption (not including change-out) and fuel consumption (to the nearest 1/10 gallon) on your equipment on a “per unit” basis? yes no
If “yes”, how far back in time do these records go (specify years and/or months)?

USE THE SPACES BELOW TO CLARIFY ANY INFORMATION REQUESTED ABOVE. PLEASE IDENTIFY EACH ITEM BY ITS ITEM NUMBER.

Item #: Comment:
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Please provide in the spaces below the name, title, telephone number, post, E-mail and Fax number of a contact person with your organization in the event we require additional information:
Name:

Title:

Telephone Number:

Post:

E-mail:

Fax:

Additional comments you would like to make regarding our website or our formulas:

You should retain one copy of the completed Proposal Data Sheets for your records.

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