CATERPILLAR TRADEMARKMERCHANDISE LICENSE APPLICATION
Caterpillar Inc.
Retail Business Development
501 SW Jefferson ST
Peoria, IL 61605-2160

COMPANY INFORMATION
Company Name: ___________________________________________________________________________________
Primary Contact: ________________________________________ Title: ______________________________________
Contact Email: _____________________________________________________________________________________
Company Address: _________________________________________________________________________________
City: _________________________________________________ State: ______ Zip: ____________________________Country: _________________________________________________________________________________________
Telephone: ( ______ ) __________________________ Fax Number: ( ______ ) ________________________________
Company Web Site: ________________________________________________________________________________
Years in Business: ________________________ Current Number of Employees: ______________________________
Description of Company:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Company ownership type: Public

 PrivatePrincipal Owner(s) (complete name and business address) and ownership %:1. ________________________________________% 2. ________________________________________%_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please list the key members of your management team:President: ___________________________________________________________________________________
Vice President: _______________________________________________________________________________
Licensing Manager: ____________________________________________________________________________
CFO: ________________________________________________________________________________________
Other: ______________________________________________________________________________________
Other: ______________________________________________________________________________________

http://www.caterpillar.com/dataprivacy

FINANCIAL INFORMATION20162015

2014

2013

Annual Gross Revenue
Last four Years:
Please provide your recent Dun & Bradstreet rating and attach a copy of the most recent report:
Number:Rating:Please provide a bank reference:
Bank Name: ________________________________________________________________________________
Address: ___________________________________________________________________________________
Contact Name/Telephone: ________________________________________ ( _____ ) ____________________
Credit References (name, business address, telephone number)

As an individual, officer of a corporation, or as a partner in a partnership, have you ever filed forbankruptcy voluntarily or been proceeded against involuntarily as bankrupt? If yes, give details - date,court, case number, etc.

PRODUCT INFORMATION
Please provide a description of the product(s) for which you seek a license:

Is a prototype or sample of the product to be sold available for review?  Yes  No
Please list other products your company sells that are not included in this license application:

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MANUFACTURING INFORMATIONWill your company manufacture this product(s) in your factory?

 Yes

 No

If not, who will manufacture this product? Name, address, telephone number:

Does your company have a formal quality control program?

 Yes

 No

If yes, what criteria are used for quality control?

Where will the product(s) be manufactured (country of origin)? __________________________________________
List the countries where you produce products in order of volume:
1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
4. _________________________________________________
5. _________________________________________________

MARKETING & DISTRIBUTIONYour firm must have marketing and distribution capabilities. Describe any advertising and promotional materials orprograms you plan to use to market the above products:

Please check off all territories where you currently sell products. For international markets list the specific countries.
USACanadaMexico Europe _______________________________________________________________________________ Central America ________________________________________________________________________ South America _________________________________________________________________________
 Middle East ___________________________________________________________________________ Asia __________________________________________________________________________________ Australia/New Zealand __________________________________________________________________ Other ________________________________________________________________________________

http://www.caterpillar.com/dataprivacy

Please list your top 10 retail “brick & mortar” accounts:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please list your top 10 retail “online” accounts:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please identify how you service retail accounts:

Please list three trade contacts we can contact and who would be able to provide us with an opinion on yourcompany's product line and performance.
Company Name

Contact Name

List the industry trade shows where you would exhibit these product(s):http://www.caterpillar.com/dataprivacy

Telephone Number

LICENSING INFORMATION
Does your company currently manufacture any other products under licensing contracts?
 Yes

 No

If yes, please specify which licenses your firm currently holds:

Please describe any other licensing experience your company may have:

Please estimate annual wholesale dollar volume of the products you wish to market under this license:
Year 1 USD$ ________________________ Year 2 USD$ ________________________
Proposed royalty rate % on wholesale price: _________ %Proposed annual minimum royalty guarantee to Caterpillar Inc. USD$ ______________
Please enclose any additional information you believe may be helpful in evaluating your license request which should
include, but not be limited to the following:
1. Non-returnable product samples at no charge to Caterpillar Inc. for evaluation of quality, workmanship,materials, etc.
2. Annual report, balance sheet and income statement.
3. Catalogs, brochures, and promotional materials which illustrate or reference your company's products.

ADDITIONAL INFORMATION
To provide for proper insurance coverage in the event of consumer litigation due to licensee marketing or products
sold by licensees, Caterpillar Inc. requires licensees to have proof of certain types of valid insurance. Proof ofinsurance is in the form of a certificate naming Caterpillar as an insured party. Coverage limits vary from $1 million
to $10 million, depending on the type of licensed articles.
Does your company currently have liability insurance?
 Yes No

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Please write any additional comments that might help us make a determination regarding this license request:

PROSPECTIVE LICENSEE STATEMENT
I am authorized to represent and obligate the company named below, and I and the company hereby attest that theinformation included herein is true and complete. I and the company understand that any license which may begranted to this company by Caterpillar Inc. is subject to immediate termination, without the return of any amount
paid or the abatement of any amount due, if Caterpillar finds that false, misleading, fraudulent or incomplete
information has been supplied.
I and the company hereby acknowledge the nature of all names, likenesses and marks of the properties represented
by Caterpillar and that until such time, if any, as a license has been issued to this company, no rights exist for usethereof.
A non-refundable application fee of $1,000.00 USD must accompany this application.
All payments are to be made by wire transfer to:
JP MORGAN CHASE ABA Number: 021000021
Account of CATERPILLAR INC. No. 9102000800

I and the company understand that this application does not constitute an offer from Caterpillar nor imply anyobligation on the part of Caterpillar to grant a license in any category.
Caterpillar may reject this application for any reason.
Submitted by:
Signature: ____________________________________________________________________
Print Name: __________________________________________________________________
Title: ________________________________________________________________________
Company: ____________________________________________________________________
Date: _______________________________________________________________________

http://www.caterpillar.com/dataprivacy