Full Legal Company Name: *

"Abbreviated" and/or "Doing Business As" and/or "Also Known As" Company Names: *

State of legal incorporation: *

List Parent, if applicable

List subsidiaries and affiliates: *

Headquarters address: *

List of locations: (If more than two locations, please link to your web site)

Company classification as indicated from your Small Business Administration (SBA) certification. * Please select 8(a) HUBZone Other than Small - Large Business Service Disabled Veteran Owned Small Business Small Business Woman Owned Small Business

Provide a brief description of your company. * Please include the vision and objectives for the Public Sector market

Company Overall Annual Revenue: *

% of Revenue from Public Sector Sales: * Please select 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%

% of Revenue from Public Sector Services: * Please select 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%

# of years selling to Public Sector entities: *

Describe your sales structure as it relates to Oracle * i.e., inside sales coverage, direct sales, business development, services sales, and the regional alignment as it relates to Oracle

(LEGACY) First Name:

(LEGACY) Last Name:

First and Last Name: *

Job Title: * (e.g., Board Director, CEO, CFO, COO, CTO, Chairman, Director, General Manager, Majority Owner (>50%), Owner/Founder, Partner, President Secretary, Sr. VP, Supervisor, VP)

Email Address: *

Phone Number: *

(LEGACY) First Name:

(LEGACY) Last Name:

First and Last Name:

Job Title: (e.g., Board Director, CEO, CFO, COO, CTO, Chairman, Director, General Manager, Majority Owner (>50%), Owner/Founder, Partner, President Secretary, Sr. VP, Supervisor, VP)

Email Address:

Phone Number:

Authorized Signer(s): *

# of Overall Employees: *

# of Employees in Sales: *

# of Employees in PreSales: *

# of Employees Delivery Focused on Oracle: *

# of Employees in Operations: * (including back office functions, accounting, contracts, and legal)

# of Employees Focused on Proposal Activities and Marketing: *

# of Years as an OPN Member: *

List achieved Expertise for Oracle products or industries.

Method(s) of Distribution (check all that apply): Application Specific Full Use Licenses Full Resell of Oracle License, Hardware and Cloud Independent Software Vendor Managed Service Provider

Line of Business Focus (check all that apply): Apps Tech SaaS IaaS/PaaS Engineered Systems Storage Consulting Services

(LEGACY) Specific Product or Service Focus. (Primavera, MySQL, Linux, Java, etc.)

Which addendum are you requesting? Public Sector Addendum to the Master Distribution Agreement Cloud Services Distribution Addendum Both

Do you have an established line of credit with Oracle? Yes No

Do you have an established line of credit with an authorized Oracle Value Added Distributor? Yes No

Define your target verticals within the Public Sector market (Federal, State and Local, etc.). *

Outline the marketing events and target market planned in the next 6 months featuring Oracle. *

Outline the sales strategy and focus for growth as it relates to Oracle. *

Describe your company’s split between Oracle software, hardware, and cloud. *

Has your company been debarred or suspended from Federal, State or Local procurement? * Please select Yes No

If Yes, please explain.

Has your company had a contract terminated for default by a Federal or State and Local Agency? * Please select Yes No

If Yes, please explain.

Provide a list of Federal and/or State and Local Contracts you currently hold or are pursuing.

List your company's top 5 completed Public Sector transactions by market (SLG or Federal or Canada). * Must specify line of business (Apps, Tech, Middleware, Cloud, Engineered Systems, Servers, or Storage) and approximate value

State/Local Oracle opportunities by line of business that you are developing for the next 6 months. *

Federal Oracle opportunities by line of business that you are developing for the next 6 months. *

I agree that: (i) the answers provided in this questionnaire are true and correct; (ii) any untrue answer constitutes just cause for the immediate termination by Oracle of my organization’s OPN membership and any distribution agreement; (iii) submitting this questionnaire electronically is equivalent to applying my signature to a legally binding document; and (iv) I have the requisite legal authority to act on behalf of my organization. I also agree to promptly notify Oracle of any material changes to the answers provided in this questionnaire.

First and Last Name: *

Job Title: *

Email Address: *

Date: * mm-dd-yyyy