COMPANY DUE DILIGENCE QUESTIONNAIRE Please type answers in the spaces provided. Company Name Address: Website: Point of Contact Name: Address: Telephone: Fax: E-Mail: 1. Management Name(s) Chairman/ President/ Executive Director Names of employee/s who will be managing company’s business relation with Putzmeister America Inc 2, Ownership If your company is listed on a major securities exchange / stock exchange or 100% ‘owned by a company that is listed on such an exchange, please attach to this, Questionnaire a copy of your most recent annual report(s) to such exchange(s), and skip the remainder of this Question 3 1 from 5Please (a) name all owners of the company and (b) state their % of ownership If any owner is itself another company, please identify the owners of that company until a natural beneficial person(s) or a publicly traded company is named for each percentage of ownership of your company (Attach separate sheet(s) if necessary.) 3__ Questions Regarding Individuals and association with Goverment | Yes [No Do any of the individuals named in your answers to Questions 2 and 3 meet the following descriptions (check all that apply) * a current or former government official (including elected or appointed officials, as well as employees, agents or representatives of any government agency or institute, government-owned or government- controlled company, public international organization or political party or government itself, * a political party official * a candidate for political office © an employee, agent or representative of a public international organization (such as UN, IMF, WHO, etc.) * an employee, agent or representative of a government agency or institute * an employee, agent or representative of a government-owned or government-controlled company * a close associate, immediate family member, or household member of any of the above .2fom 5Do you or any individual named in Question 2 or any of their family/household members formally make or formally influence decisions or recommendations regarding any of the following: approval of licensing, registration or permitting; approval of land title registration; approval of product purchase (Putzmeister products or related products) on a committee or requisition board; approvals related to work permits or travelivisa documents, or otherwise influence or assist in the granting of government approvals and/or influence the business relation with Putzmeister America Inc? 4,_ Questions Regarding Penalties Yes | No Has a criminal or civil penalty ever been imposed against your company or any of the individuals named in Questions 2 or 3 for corruption or fraud? Has your company or any individual named in Question 2 or 3 ever been suspended or debarred by any licensing agency? 5. IFany other companies will perform any services or receive any payments in connection with your company's work for Putzmeister America Inc, please answer the following: (Attach separate sheet(s) if necessary) Please list all other companies in which the individuals named in Question 2 or 3 have an ownership interest or management position (State name of individual, name of business, Position at business and/or % ownership) Please list all subsidiaries of your company and any sister companies and/ or sister organizations Please list any companies or organizations jointly owned by your company (State name of any jointly owned companies, names of the joint owners, and the % ownership) p.3trom 5.6. Business References Please provide the names of all other companies and individuals with which you have a relationship similar to the proposed business relationship with Putzmeister America Inc. 7. Explanation If you answered YES to any query in Questions 4, 5 please attach a description that includes for each referenced individual or company: the name of the individual or company; the length of its association with your company; and the position, title and/or nature of work (as appropriate) of the individual or company. In addition, If you answered YES to any query in Question 4, please state: * whether the referenced public official (meaning the government official, political party official, political candidate or official/ agent of a public international organization) or company has any discretion that could be used to the benefit or detriment of Putzmeister America Inc (if so, please describe); and + whether company’s relationship with the public official/ company is/ was formally disclosed to any government, political, or public agency with which they have a continuing association (if so, please provide a copy) If you answered YES to any query in Question 5, please describe the circumstances of and reason for such penalty. If you answered YES to any query in Question 6, please provide a description of such services and/ or payments, including their location and purpose. 8. Certification Ihereby certify that | am a duly authorized representative of the company named below; that the information | have provided is true and complete to the best of my knowledge; that | understand that Putzmeister America Inc will rely on this information with regard to the business cooperation with the company; that | consent to Putzmeister America Inc representatives making such inquiries as they may consider necessary to verify this information and to process, store and transfer such information ; and P.4 from‘that in connection with the company's business with Putzmeister America Inc, | have not given and will not give or attempt to give, and no officer, director, shareholder or employee of the company has given or will give or attempt to give, to anyone, directly or indirectly, anything of value for the purpose of obtaining or retaining by unfairness any business or gaining any improper advantage from a government official Company Signature: Typed or Printed Name: Date: Strom: