* Required information. Company Information Company Name: * Number of Employees: Federal Tax Number (GST or EIN) Street/Mailing address of office completing this questionnaire Address: * City: * Province/State: * Country: * Website: Postal/Zip Code: Phone Number: * Fax Number: Key Company Sales Contact Name: * Phone Number: * Email: * Head Office Address: * City: * Province/State: * Country: * Website: Postal/Zip Code: Phone Number: * Fax Number: Type of Company * Please select one of the following: Sole Proprietor Partnership Corporation - Private Corporation - Public Other (please identify): Please indicate if you are a business where 51% of the ownership is by one or more of the following groups: Female Person with Disability Visible Minority Does your company’s ownership structure include at least 25% ownership by an Aboriginal community or a member of an Aboriginal community? Yes No If Yes, please identify the Aboriginal Community / First Nation: Which provinces/territories/states/countries, etc. are you licensed to do business in? * Please select one or more of the following: British Columbia Alberta Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Newfoundland P.E.I. Yukon Northwest Territories Nunavut (identify other regions): United States (identify which states): Great Britain Central America Asia Pacific Rim Europe South America Other Health, Safety and Environment Do you have valid Workers’ Compensation (WCB) coverage? Yes No Do you have a safety program? Yes No Do you track HSE (Health, Safety and Environment) performance statistics? Yes No Is your company a current subscriber to ISNetworld, Husky’s outsourced partner for supplier prequalification? Refer to www.isnetworld.com for information. Yes No If yes, please provide your ISN rating: Please select primary category of business * Category: Ancillary Oilfield Services Artificial Lift Equipment Chemicals Completions Services Construction Materials Construction Services Corporate Communications Corporate Responsibility Corporate Services Drilling and Completions Services Drilling Services Engineering Services Exploration Services Finance Services Fuel and Lubricants Human Resources Information Services Legal Services Logistics Maintenance Services Marine Operations and Services Marketing Services MRO Offshore Operations Services Operations Services Process and Occupational Safety Production Equipment Rigs Special Projects Speciality Construction Services Subsea Travel Facilitation Vehicle Fleet Well Materials Wellsite Equipment and Service Sub-Category: Surface Land Agents Vacuum Water Hauling Attenuated Buildings and Wooden Pumphouses Chemicals - Enhanced Oil Recovery (EOR) Chemicals - Non Conventional Chemicals - Process Chemicals - Production Chemicals - Services Chemicals - Water Treatment Gases Coil Tubing Services Completion Downhole Tools Electronic Wireline, Perf and Logging Production Testing Production tracers Slickline Services Snubbing Services Stimulation Fluids Stimulation Services Tubing Conveyed Perforating Building Construction Materials Civil Construction Materials Field Erected Tanks Non Metallic Pipe Materials Structural Materials Building Construction Services Civil Construction Materials Civil Construction Works Electrical Construction Services Fabrication Facility Construction Field Erected Tanks Instrumentation Construction Services Module Assembly Pipeline Construction and Maintenance Speciality Construction Services Topographical Services Corporate Communication Material Corporate Communication Services Emergency Response Services Environmental Operations Security Services Waste Management Corporate Facilities Management Office Services Real Estate Services Core Sampling and Storage Services Offshore Completions Services Offshore Drilling and Completions Contract Labour and Consulting Services Offshore Drilling and Completions Technical Services and Software Support Offshore Drilling Services Offshore Drilling Tools and Accessories Offshore Rigs Offshore ROV Services Pipeyard and Tubular Management Services Well Site Survey Services Cementing - Primary and Remedial Directional Drilling Drill Bits Drilling Fluids Drilling Tools / Pipe Electronic Monitoring Services Fishing Tools and Services Power Tongs / Torque Monitoring Services Underbalance Drilling Services Engineering Services, Multidiscipline Geotechnical Inspection Services Offshore Engineering Services Core Sampling Formation Evaluation Mapping/Permitting/Approvals Offshore Seismic Services Seismic Finance Services - Accounting Services Finance Services - Treasury Tax Services Fuel - Coal and Other Solid Fuel Fuel - Diesel Fuel - Gasoline Fuel - Natural Gas Fuel - Oil Lubricants Advisory Services Contract Labour Human Resources Professional Services IS Hardware and Accessories IS Hardware Maintenance and Support IS Services IS Software IS Software Services IS Telecom Equipment and Accessories IS Telecom Services IS Telecom Networks Legal Services Freight Services Logistics - Customs and Duties Logistics - Rig Moving Logistics Services Storage Services Maintenance Services - Facility and Assets Rotating Equipment Maintenance Safety and Fire and Gas Systems Maintenance Marine and Logistics Contract Labour and Consulting Services Marine and Logistics Technical Services and Software Support Offshore Helicopter Services Offshore Ice Reconnaissance Offshore Marine Base Services Offshore Marine Fuel Offshore Shuttle Tankers Offshore Support Vessels Offshore Warehousing and Materials Management Offshore Weather Forecasting and Oceanographic Services Commercial and Industrial Sales Convenience and Restaurant Marketing Marketing Marketing Construction Services Marketing Maintenance Services Retail / Commercial Infrastructure Fittings Industrial Consumables (MRO) Pipe - Process Valves Marine Crewing and Support Offshore Accommodations Services Offshore Diving and Dive Support Services Offshore Environmental Services Offshore Fabrication and Marine Welding Services Offshore Inspection Services Offshore Lifeboat, Fire and Safety Systems Offshore Maintenance Services Offshore Oil and Gas Metering Offshore Operations Contract Labour and Consulting Services Offshore Operations Technical Services and Software Support Offshore Production Chemicals Offshore Safety Training Offshore Telecommunications, Software and Technical Support Offshore Valves Equipment Rentals - Production Fluid Hauling Services Hydrovac Services Laboratory Services Sand Management and Trucking Services Health and Medical Services Safety and Protective Equipment Safety Services Artificial Lift Equipment Electrical Instrumentation Rotating Mechanical Equipment Static Mechanical Equipment Coil Tubing Rigs Coring Rigs Drilling Rigs Rod Rigs Service Rigs Special Corporate Projects Concrete Foundation Services Offshore Subsea Equipment Offshore Subsea Equipment Storage and Maintenance Travel and Meeting Facilitation Services Travel Services - Accommodation Travel Services - Commercial Air Travel Services - Fixed-Wing Charter Air Travel Services - Ground Transportation Travel Services - Rotary-Wing Charter Air Fleet Management Services Vehicle Fleet - Acquisition and Disposal Vehicle Fleet - After-Market Upfitting Vehicle Fleet - Operating Costs Inflow Control Line Pipe OCTG OCTG Coating OCTG Inspection Rods and Scrapers Tubular Planning and Management Services Wellheads Camps and Catering Surface Equipment Please describe any innovative technologies & operational efficiencies that your company will be able to deploy for Husky: (max 200 characters): You have 200 characters left. Please describe the value-added services that your company can provide to Husky: (max 200 characters): You have 200 characters left. Please verify the CAPTCHA.