Remanufacturer Form

Person Who Will Represent Your Firm in PERA

Title

President of Firm (If Different From Above)

Firm Name

Street Address

City, State & Zip/ Postal Code

Country

Phone

Fax

Email

Website

Subsidiary of

Ownership of Company
  Privately Held  Publicly Held

Date Started in Business

Letter of Recommendation

Products and services offered by your company

Please list the PERA members who have been your customers for at least one year

Please answer the following questions as of the date of this application

Annual Production of Engines

Last Year


Year Before

Average Number of Engines in Inventory Each Month

Total Number of Employees

Total Number of Shop Employees

List 5 Current Parts Sources

Shop Equipment and Quantity

Align Hone (Bore)
Cylinder Hones
Crankshaft Grinders
Boring Bars
Camshaft Grinders
Surface Grinders/ Broachers

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