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| 3. | Optional: If you want delivery to your home or Business P.O. Box, please complete the area below. |
| | What is the approximate number of employees in your company? (select only one) |
Yes, please auto-fill my contact information for other publication qualification forms.
| 4. | In lieu of a signature, BNP Media requires a unique identifier used only for subscription verification purposes. How many letters are in your father's first name? |
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| 7. | Your primary business activity: (select only one) |
| 8. | Your primary job function: (select only one) |
| 9. | Your purchasing authority: (select only one) |
| 10. | Your annual sales volume: (select only one) |
| More than $10,000,000 |
$500,001 - $1,000,000 |
| $5,000,001 - $10,000,000 |
$250,001 - $500,000 |
| $1,000,001 - $5,000,000 |
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GOVERNMENT EMPLOYEES: Please check the level of government in which you are employed.
City and Municipality
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State (Highway and Toll Road)
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PRIVATE INDUSTRY EMPLOYEES: Please check below a category which best describes your firm.
Contractor
Engineering Consulting
Producer
Other
Please specify for Other.
| | If your firm is a contractor or consulting engineer firm, please check all activities in which your firm is involved: (select all that apply) |
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Government Administrators - Mayor, City/Town/Village Manager, Administrator, Commissioner, Council Member, Director, Superintendent/Supervisor Public Works, Health, Service, Safety Officials, City/County/District Engineer, Clerk, Airport Manager, Engineer, other Government Administrator.
Corporate Management - President, CEO, Chairman, Owner, Partner, Exec/Senior VP, VP, Secretary, Treasurer, Financial Officer, Financial, Purchasing Manager, Office, Branch Manager, other Corporate Manager.
Operations - General Manager, Director, VP, Manager (Area, Factory, Plant, Product, Division), Supt. of Streets, Highway/Road Supt., Project Engineer, Maint. Supt., Supervisor, Foreman, Operator, Chief Operator, Equipment Operator, other Operator.
Engineering - Vice President, Director, Managing, Chief, Senior, Resident, Staff, Sanitary, Design, Mechanical, Architect, Estimator, Electrical, Chemical, Maintenance, Civil, Structural, Field, Construction, Environmental, EPA, Safety, Traffic, Highway, Road, Consulting, other Engineer.
Technical - Research, Scientist, Biologist, Chemist, Analyst, Environmental and Pollution Control Spec., Tech. Mgr., Supt. Supv., Foreman, other Technician.
Marketing & Sales - Manager of Marketing/Sales, other Sales/Marketing Person.
Other
Please specify for Other.
| | Buying Authority: In the performance of my job I have the authority to specify, select or approve the acquisition of the following: (select all that apply) |
| Earthmoving, excavating, grading and related equip. |
Bridge deck and rail crossing pads. |
| All paving, planning and recycling equipment systems including breakers and compactors. |
Bridges & viaduct structural components & materials. |
| Lifting and hoisting equip. for shop and/or field. |
Computers - Hardware (including workstations, printers, plotters, peripherals) and Software (including CAD, GIS and scheduling). |
| Road maintenance equipment, mowers, plows, sweepers, spreaders and accessories. |
Equipment Leasing/Rental. |
| Trucks, trailers and hauling equipment. |
Financing/Insurance. |
| Road construction materials, including additives, emulsions, sealants, surface treatments, geotextiles. |
Design/Consulting/Engineering Services. |
| Herbicides, applicators and chemicals. |
ITS Technology/Equipment/Services. |
| Lighting, poles, posts, striping, signs and supports, and other road and traffic safety equipment. |
Stormwater/Erosion Control Products |
| Compressors, welding equip., generators, pumps & other general utility equip. for shop and/or field. |
None of the Above |
| Engines, components, parts, equip. maintenance, tools, replacement elements and lubricants. |
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How many Employees in your company? |
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What is your Budget? |
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What industry do you work in? |
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What features do you require? |
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