Electrolux

Factory Profile Questionnaire

(Note: Factory management will complete a form for each separate facility.)

Date Issued:

Name of Licensee / Vendor:         Licensee / Vendor #:

Region:

Name of Factory:                   Factory #:

Physical Address:

Mailing Address:

Telephone #:

(Please review information above, make changes on form if necessary.)

FACTORY:

Ownership Type of Factory:

       Joint Venture / Partnership / Corporation / Private Owned

       Foreign Investment / Other__________

Name of Broker / Agent (if applicable):

Mailing Address:

Telephone #:                  Fax #:

FACILITY (Note:Complete a quesionnaire for each facility location)

Ownership Type of Facility:

       Joint Venture / Partnership / Corporation / Private Owned

       Foreign Investment / Other__________

Year Facility Established:

Name of Plant Manager:

Telephone #:                      Fax #:

Articles Produced:

Total Employees at this facility:  Contract:__________  Local: ___________

If contract workers employed, length of contract:

Street Address of Domitories (if applicable):

SUBCONTRACTING FACILITIES OR SISTER COMPANIES

Name(s):

Location(s):

Operations performed:

NUMBER OF MACHINES - Specify the following: