经销商申请表.pdf

Prospective Dealer Application HDMC-SRO(Mar-2006)Page 1 of 18经经销销商商申申请请表表哈哈雷雷戴戴维维森森（上上海海）商商贸贸有有限限公公司司经经销销商商网网络络发发展展部部 收收地地址址:中中国国上上海海延延安安西西路路 1118 号号龙龙之之梦梦大大厦厦 2205 室室邮邮编编：200052您是从哪里了解到可以成为哈雷戴维森经销商机会的？网络 朋友推荐 其它对于想成为哈雷戴维森经销商的每一个业主来说，都要填写一份经销商申请表（“申请表”）。我们相信您理解，在任何情况下，您提交给哈雷戴维森摩托车公司的申请表，以及其它任何文件，或者我们随后的审查和处理，都不能被理解为是任何形式的哈雷戴维森摩托车公司对您成为哈雷戴维森经销商的批准。在摩托车经销商合同完全签定以前，不能认为申请者已经被哈雷戴维森摩托车公司接受和批准。任何哈雷戴维森摩托车公司的雇员或代表都没有免除或偏离上述程序的权力；并且，当与申请程序的偏离产生时，对申请程序的免除或偏离不能认为是哈雷戴维森摩托车公司所要求的。申申请请者者姓姓名名(“申申请请者者”):_申请者特此向哈雷戴维森摩托车公司提出申请，要求批准其根据本申请表中所述条款于以下地点经营哈雷戴维森经销业务。场场所所(省省份份，城城市市):Prospective Dealer Application HDMC-SRO(Mar-2006)Page 2 of 18指指定定哈哈雷雷戴戴维维森森授授权权经经销销商商声声明明申申请请者者姓姓名名:申申请请者者特特此此提提交交申申请请，要要求求考考虑虑将将其其指指定定为为哈哈雷雷戴戴维维森森产产品品的的授授权权经经销销商商。申请者请求哈雷戴维森公司考虑授权申请者，允许申请者提供哈雷戴维森摩托车、零配件以及多样化商品的零售和产品服务。申请者理解哈雷戴维森摩托车公司没有义务接受本申请，并且申请者同意，在寻求成为哈雷戴维森授权经销商时所发生的任何费用由申请者自负，不管申请的结果是如何。申请者在此提供的信息是申请者所掌握的全部情况并且是申请日业务运营的准确描述。申请者不知晓任何提交本申请表后将对业务产生重要影响的事件。申请者在此同意，若申请者是一个公司，那么在申请成功后申请公司的管理者出于哈雷戴维森摩托车公司或相关公司的利益，将签定一份经销商协议附件形式的保证书。若有任何在提交本申请表之前和之后提供的信息被证明为虚假或误导，那么哈雷戴维森摩托车公司保留废止任何基于此申请表而确立的安排的权利。申请者签名:职务:代表:公司名称:日期:Prospective Dealer Application HDMC-SRO(Mar-2006)Page 3 of 181.申申请请者者概概况况1.1 如如果果申申请请者者是是一一个个公公司司:公司名称：主营业务:法人代表:年度收入：净收益:请附上管理层的履历表。请添加与您业务有关的任何信息（比如：年度报表、照片等）如如果果申申请请者者是是合合伙伙制制或或单单独独的的业业主主：个人姓名:私人地址：个人姓名:私人地址:个人姓名:私人地址:请附上个人/合伙人的履历表。请添加与您业务有关的任何信息（比如年度报表、照片等）请请描描述述您您的的业业务务优优势势：请解释您的业务优势:申请者是否有零售业务经验，特别是在汽车、摩托车和/或奢侈品行业？申请者是否有摩托车和相关赛车运动的任何经验？补充信息:注意：对于所有有意成为经销商的业主，都需要提供申请者信息。Prospective Dealer Application HDMC-SRO(Mar-2006)Page 4 of 182.财财务务信信息息2.1 如如果果申申请请者者是是一一个个公公司司，请请您您提提供供您您最最近近经经审审计计的的财财务务报报表表，包包括括资资产产负负债债表表、损损益益表表以以及及现现金金流流量量表表。指定审计人:联系人姓名:地址:电话号码:传真号码:2.2 如如果果申申请请者者是是合合伙伙制制或或单单独独业业主主，请请提提供供格格式式适适当当得得体体的的个个人人财财务务报报表表，列列明明您您的的资资产产（比比如如，现现金金、股股票票、房房地地产产等等），债债务务（比比如如，应应付付款款项项、贷贷款款等等）以以及及资资产产净净值值。2.3 您您对对于于哈哈雷雷戴戴维维森森零零售售业业务务的的财财务务融融资资计计划划是是什什么么？资金来源：金额及期限等条款：来源数目：总金额：注意：最低投资要求/来源的估计将超过人民币五百万元。不过，一个新的经销商的内部运营成本和场所成本在许多因素的基础上可能会有所变化，这些因素包括市场规模、物业成本以及场所成本。实际的要求应该遵照最终的商业计划和实际的市场条件。以下签名确认本公司或个人的财务报表以及任何附件（提供了在以下签署日期的完整、真实、以及准确的公司或个人的财务状况）。申请者签名日期Prospective Dealer Application HDMC-SRO(Mar-2006)Page 5 of 183.场场所所3.1 如如果果你你目目前前拥拥有有一一处处用用于于其其它它业业务务的的场场所所并并打打算算将将此此场场所所用用于于哈哈雷雷戴戴维维森森经经销销业业务务：地址:位置描述:场所面积:平方米车辆区域:平方米零配件区域:平方米多样化商品区域:平方米维修服务区域:平方米仓库:平方米办公室:平方米租赁 年成本:自有年成本:您初步的转业计划是:在目前场所，申请者是否拥有任何其它汽车/摩托车特许经销权？如果有的话，请写明特定的特许经销商名称。UUU是/否UUU特许经销商名称:UUU特许经销商名称:在目前场所，是否有任何其他的汽车/摩托车经销商？如果有的话，请写明特定的品牌并作总体情况描述。UUU是/否UUU品牌:UUU描述:申请者在其它地方是否有任何其它汽车/摩托车特许经销权？如果有的话，请写明特许经销商名称和位置/地址。UUU是/否UUU特许经销商名称:UUU位置/地址:UUU特许经销商名称:UUU位置/地址:补充信息:请提供照片描述场所环境和位置。请提供地图并标明您的场所位置。请提供草图描绘您用于哈雷戴维森业务的场所设计规划。Prospective Dealer Application HDMC-SRO(Mar-2006)Page 6 of 183.2 如如果果您您为为哈哈雷雷戴戴维维森森提提议议一一个个新新的的经经营营场场所所：地址:位置描述:场所面积:平方米车辆区域:平方米零配件区域:平方米多样化商品区域:平方米维修服务区域:平方米仓库:平方米办公室:平方米租赁 年成本:自有年成本:在目前场所，申请者是否拥有任何其它汽车/摩托车特许经销权？如果有的话，请写明特定的特许经销商名称。UUU是/否UUU特许经销商名称:UUU特许经销商名称:在目前场所，是否有任何其他的汽车/摩托车经销商？如果有的话，请写明特定的品牌并作总体情况描述。UUU是/否UUU商标:UUU描述:申请者在其它地方是否有任何其它汽车/摩托车特许经销权？如果有的话，请写明特许经销商名称和位置/地址。UUU是/否UUU特许经销商名称:UUU位置/地址:UUU特许经销商名称:UUU位置/地址:补充信息:请提供照片描述场所环境和位置。请提供地图并标明您的场所位置。请提供草图描绘您用于哈雷戴维森业务的场所设计规划。Prospective Dealer Application HDMC-SRO(Mar-2006)Page 7 of 184.人人员员4.1 提提议议人人员员经销商负责人:资格:总经理:资格:摩托车销售主管:资格:零配件销售主管:资格:多样化商品销售主管:资格:维修服务经理:资格:4.2 请请提提交交一一份份组组织织结结构构图图。Prospective Dealer Application HDMC-SRO(Mar-2006)Page 8 of 185.其其它它信信息息请您填写完整以下信息。5.1 为什么您想成为哈雷戴维森的经销商？5.2 您将在新提议的经销商中担任什么职务？5.3 请描述经销商的经营规模（年销售量等）。5.4.您看到了什么机会？关键的挑战是什么，您将如何应付这些挑战？5.5 为什么您认为您有资格拥有/管理一家哈雷戴维森经销商？5.6 请在此添加您愿意我们考虑的任何其它信息。Prospective Dealer Application HDMC-SRO(Mar-2006)Page 9 of 186.财财务务状状况况以以及及背背景景审审核核调调查查请与经销商申请表一起提交致：相关人员签名人理解哈雷戴维森摩托车公司将根据签名人申请的有关事项进行背景和财务状况分析，财务状况分析包括与其它事项并存的信用调查。签名人授权哈雷戴维森摩托车公司进行此类背景和财务状况分析，并且在进行此类背景和财务状况分析时，可以不受限制地对提交给哈雷戴维森摩托车公司的报表进行验证，以及获得和分析哈雷戴维森摩托车公司认为必要的有关签名人的财务状况、信用资质、企业和专业特质、机动车辆经验和个人特征的信息。签名人授权哈雷戴维森摩托车公司分享在背景和财务状况分析中所获得的信息对本申请表进行分析和处理。若本申请是关于经销商收购或经销商产权利益收购的，则签名人授权哈雷戴维森摩托车公司向经销商或经销商产权利益（根据具体情况而定）的出让方披露调查所揭示的签名人的全部或部分信息，这些信息有关签名人的信用资质、企业和专业特性、机动车辆业务经验和个人特征等。（个人签字）（企业名称）姓名正楷：（其他个人签字）姓名正楷：（企业负责人签字）姓名正楷:职务正楷:Prospective Dealer Application HDMC-SRO(Mar-2006)Page 10 of 18PROSPECTIVE DEALERAPPLICATIONHarley-Davidson(Shanghai)Commercial&Trading Co.,LTDAttn:Dealer DevelopmentRoom 2205 Cloud Nine Plaza1118 West Yanan RoadShanghai 200052ChinaSOURCE THROUGH WHICH YOU LEARNED OF HARLEY-DAVIDSONDEALERSHIP OPPORTUNITY Website Referral OtherA Prospective Dealer Application(“Application”)must be completed by each prospective ownerof a Harley-Davidson dealership.We trust you understand that under no circumstances does thesubmittal of your application and any other documents to Harley-Davidson Motor Company orour subsequent review and processing imply in any manner Harley-Davidson Motor Companysintention to approve you as a Harley-Davidson dealer.The Applicant shall not be deemed to beaccepted and approved by Harley-Davidson Motor Company unless and until the full execution ofMotorcycle Dealer Contract(s).No employee or agent of Harley-Davidson Motor Company hasthe authority whatsoever to waive or otherwise deviate from the foregoing procedures,and shouldany deviation of the application procedure occur,the waiver or deviation from the applicationprocedure shall not be binding upon Harley-Davidson Motor Company.APPLICANT NAME(the“Applicant”):_Applicant hereby applies to Harley-Davidson Motor Company for approval to operate aHarley-Davidson dealership in the following location,subject to the terms and conditions stated inthisApplication.LOCATION(City,Province):Prospective Dealer Application HDMC-SRO(Mar-2006)Page 11 of 18DECLARATION FORAPPOINTMENT ASANAUTHORISEDHARLEY-DAVIDSON DEALERNAME OFAPPLICANT:Applicant hereby submits for consideration an application for appointment as an authorizedDealer of Harley-Davidson product.ApplicantrequeststhatconsiderationbegiventorepresenttheretailsaleofauthorizedHarley-Davidson motorcycles,Parts,Accessories&Merchandise(PAM)and the servicing ofHarley-Davidson products.Applicant understands that Harley-Davidson Motor Company is not obliged to accept this applicationand Applicant agrees that any expense incurred in seeking appointment as an authorizedHarley-Davidson Dealer is solely the applicants responsibility,irrespective of outcome.The information Applicant provides herein is to the best of applicants knowledge,an accurate accountof the business operation at the date of application.Applicant is not aware of any event which islikely to significantly affect the business after the submission of this application.Applicant acknowledges that if the applicant is a corporation,and if successful in this application,thedirectors of the applicants corporation will be required to execute in favor of Harley-Davidson MotorCompany or is related companies a guarantee in the form annexed to the Dealer Agreement.Should any information provided either prior or subsequent to the submission of this application proveto be false or misleading,Harley-Davidson Motor Company reserves the right to rescind anyarrangement entered into on the basis of this application.Signature of Applicant:Title:For and on Behalf of:Company Name:Dated:1.APPLICANT PROFILEProspective Dealer Application HDMC-SRO(Mar-2006)Page 12 of 181.1 If theApplicant is a Corporation:Company Name:Main Business:Legal representative:Annual Revenue:Net Profit:Please attach managementsCVs.Please include any information on your business(e.g.annual report,pictures,etc.)If theApplicant is partnership or sole owner:Individual Name:PrivateAddress:Individual Name:PrivateAddress:Individual Name:PrivateAddress:Please attach each individuals/partners CV.Please include any information on your business(e.g.annual report,pictures,etc.)To describe your business strengths:Please explain your business strengths.Does applicant have retail business experience,especially in vehicle,motorcycle and/or luxurygoods industry?Doesapplicanthaveany experiencewithmotorcycles and related motor sports?Supplements:Note:Applicant information will be required for all proposed dealership owners.2.FINANCIALProspective Dealer Application HDMC-SRO(Mar-2006)Page 13 of 182.1 If the Applicant is a corporation,please provide a copy of your most recently auditedfinancial statements,including Balance Sheet,Profit&Loss Statements and Statement ofCash Flow.Nominated auditors:Contact Name:Address:Telephone number:Fax number:2.2 If the Applicant is a partnership and sole owner,please provide decently formattedpersonal financial statements to clearly state your assets(e.g.cash,stocks,real estate,etc.),liabilities(e.g.payables,loans,etc.)and net worth.2.3 Whats your financing plan for H-D retail business?Funding resourcesAmount and termsNumber of resources:Total amount:Note:Estimates of minimum investment requirements/resource needs are in excess of RMB5million.However,the internal operation and facility costs of a new dealership will vary,predicated on many factors,including market size,property costs,and facility costs.Actualrequirements will be subject to final business plan and actual market conditions.The undersigned certifies that this Business or Personal Financial Statement and any attachmentshereto(provide a full,true,and correct statement of the business or personal financial condition ofthe undersigned as of the date indicated.)Applicant SignatureDate3.FACILITIESProspective Dealer Application HDMC-SRO(Mar-2006)Page 14 of 183.1 If it is a current facility which you are using for another business and you are going touse it as H-D dealership:Address:Location description:Dimension of this facility:sq.ms.Vehicle area:sq.ms.P&Aarea:sq.ms.GM area:sq.ms.Service area:sq.ms.Warehouse:sq.ms.Office:sq.ms.Leased Annual cost:Owned Annual cost:Your rough transfer plan:Any other motorcycle/car franchises held bytheApplicant on the current site?If yes,please give specific franchise names.UUUYes/NoUUUFranchise name:UUUFranchise name:Any other motorcycle/car dealer on the currentsite?If yes,give specific brand names and generaldescription please.UUUYes/NoUUUBrands:UUUDescription:Any other motorcycle/car franchises held bytheApplicant elsewhere?If yes,please advise Franchise Names andLocation/address.UUUYes/NoUUUFranchise Name:UUULocation/address:UUUFranchise Name:UUULocation/address:Supplements:Please provide pictures to describe the facility environment and location.Please provide a map to highlight the location of your facility.Please provide sketches to describe your facility design idea for H-D business.3.2 If you are proposing a new facility for H-D dealership:Prospective Dealer Application HDMC-SRO(Mar-2006)Page 15 of 18Address:Location description:Dimension of this facility:sq.ms.Vehicle area:sq.ms.P&Aarea:sq.ms.GM area:sq.ms.Service area:sq.ms.Warehouse:sq.ms.Office:sq.ms.Leased Annual cost:Owned Annual cost:Any other motorcycle/car franchises held bytheApplicant on the current site?If yes,please give specific franchise names.UUUYes/NoUUUFranchise name:UUUFranchise name:Any other motorcycle/car dealer on the currentsite?If yes,give specific brand names and generaldescription please.UUUYes/NoUUUBrands:UUUDescription:Any other motorcycle/car franchises held bytheApplicant elsewhere?If yes,please advise Franchise Names andLocation/address.UUUYes/NoUUUFranchise Name:UUULocation/address:UUUFranchise Name:UUULocation/address:Supplements:Please provide pictures to describe the facility environment and location.Please provide a map to highlight the location of your facility.Please provide sketches to describe your facility design idea for H-D business.4.PEOPLEProspective Dealer Application HDMC-SRO(Mar-2006)Page 16 of 184.1 Proposed StaffingDealer Principal:Qualifications:General Manager:Qualification:MC Sales Manager:Qualifications:P&ASales Manager:Qualifications:GM Sales Manager:Qualifications:Service Manager:Qualifications:4.2 Please submit an organization chart.5.OTHER INFORMATIONProspective Dealer Application HDMC-SRO(Mar-2006)Page 17 of 18We ask for your cooperation in completion of the following information.5.1 Why do you want to be a Harley-Davidson dealer?5.2 Define your perceived role in the proposed new dealership.5.3 Indicate the size of the dealership envisaged(annual sales,etc.).5.4.What opportunities do you see?What are the key challenges and how would you over comethem?5.5 Why do you feel you are qualified to own/manage a Harley-Davidson dealership?5.6 Please include any other information you would like us to consider.6.FINANCIALAND BACKGROUND REVIEW INVESTIGATIONProspective Dealer Application HDMC-SRO(Mar-2006)Page 18 of 18PLEASE SUBMITWITH DEALERSHIPAPPLICATIONTo Whom It May Concern:The undersigned understand(s)that Harley-Davidson Motor Company will be performing thebackground and financial analysis of the undersigned in connection with the Application of theundersigned.The financial analysis includes,among other things,a credit investigation.The undersigned authorize(s)Harley-Davidson Motor Company to perform such background andfinancial analysis and,in performing such background and financial analysis,to without limitation(i)verify statements made to Harley-Davidson Motor Company and(ii)obtain,review andanalyze such information concerning the financial condition,credit standing,business andprofessional character,motor vehicle experience and personal characteristics of the undersigned asHarley-Davidson Motor Company deem necessary.The undersigned authorize(s)Harley-Davidson Motor Company to share the information obtainedas a part of the background and financial analysis with each other for the purposes of analyzingand processing this application.If this application is being provided in connection with thepurchase of a dealership or the purchase of an equity interest in a dealership,then the undersignedauthorize(s)Harley-Davidson Motor Company,to disclose to the seller of the dealership or theseller of the equity interest in the dealership,as the case may be,all or any part of the informationon the undersigneds credit,business and professional character,motor vehicle experience andpersonal characteristics discovered as a part of the investigation.(As Individual)(Name of Business)Print Name:By:(Other Individual)(As Officer of Business)Print Name:Print Name:Print Title: