ALLSTATE DIVERSE SUPPLIER MENTORING APPLICATION
Company Name:
Headquarters Address:
Facility/Plant Address:
Website Address:
City: / State: / Zip Code:
Company Owned By: / % Ownership:
Name of CEO/President:
Years in Operation: / Incorporation Date:
Federal ID Number:
Company Contact:
Name:
Title:
Address:
E-mail Address:
Type of Business: / Manufacturer/Assembly Service/Distributor
Repair Other (describe)
List all products and/or services provided by your company:
SIC Codes (Primary and Secondary):
List all Certifications:
Are you a current Allstate supplier? Yes No
If your company has ever had legal actions taken against it and/or been sued, please provide us detail:
Do you foresee your company being sold, merged with or taken over in the next 24 months?Yes No
OWNERS/MANAGEMENT
Have there been any significant changes in ownership within the last 2 years?YesNo
If yes, please describe:
What role do the owners take in managing the Company?
(Please attach an organization chart with the application)
Who are the key leaders of the Company? What are their backgrounds, experiences, and functions?
WORKFORCE DEVELOPMENT
Total employment of permanent workers (W2):
Total employment of contract workers (1099):
Ethnic make-up percentage of your workforce: / African American: Hispanic:
Asian – Indian: Native American:
Asian – Pacific:
FINANCIAL INFORMATION
The past 12 months sales from Allstate, if applicable:
Total 2009 and 2010 sales in U.S. $$:
Forecasted 2011 sales in U.S. $$:
What internal costs do you track?
What is the capital structure of the Company?
How is budgeting done? Please describe the process.
Who is your primary resource for capital expenditure funding?
Please attach a copy of your most recent Balance Sheet and/or Statement of Cash Flows.
Are you receiving incentive dollars from governmental resources?YesNo
If yes, please quantify by resource:
TECHNOLOGY INFRASTRUCTURE
Please describe your technology infrastructure currently in use:
- Hardware:
- Operating system:
- Software:
- Number of users:
- What specific transaction sets are you now performing? (i.e. purchase order, purchase order acknowledgement, ship notice, invoice, etc.)
Do you have a disaster recovery plan in place that has been documented and tested? YesNo
What is your e-commerce strategy?
MARKETING/SALES
Please provide details on each of your products/services and their percentage of total sales:
Product line / Sales $$ / % of Total Sales
To what markets are your products sold? / Market Share %
Through which channels are products distributed to each market?
Who monitors significant customer relationships?
What are the key techniques used to promote and sell your products/services?
What proportion of customer orders are long term commitments versus spot buys?
How do you develop new customers?
Why do think your customers remain with you?
How are your prices set?
ALLSTATE DIVERSE SUPPLIER MENTORING PROGRAM
Why are you interested in participating in the Allstate Diverse Supplier Mentoring Program?
How did you hear about the program?
List the top three areas that your company needs assistance.
What do you have to offer the program?
Please list all other mentoring programs that your company has participated in the past 3 years?
What characteristics do you find most helpful in a mentor?
Do you have any travel/financial restrictions that would prohibit you from traveling to our Illinois offices during the time period of the program?
Are you willing to sign a Non-Disclosure Agreement? Yes No
Confidential
Solely for use by members of Allstate management who have a need to know. Not to be disclosed to or used by any other person
without prior authorization. May not be used, reproduced or disclosed in whole or part.