Registration for performance of the work envisaged in cost estimate no.

Made by(ITC contact person)

Identificationof the company / organisation

Name

AcronymTax ID number

Fiscal addressPostcode

TownCountry

Phone number(s)

Fax Mobile phone

Web sitee-mail

Details of the facilities if they do not coincide with the fiscal address

Contact persons

Manager or generalmanager e-mail

Head of finances or administration e-mail

Head of human resourcese-mail

Head of marketing e-mail

Head of designe-mail

Head of quality and/or environment e-mail

Principalcontact e-mail

Post:

Other contacts of interest (name, post, e-mail)

Areas of interest

Sustainable ceramic processes Energy efficiency in building construction New components and systems with ceramics

Traditional ceramic products Advanced ceramics Application of nanotechnology

Simulation and modellingSmart production Design

Materials characterisation

Others

Through:

Technology consulting R&D projects Training Analysis and tests

Company activity

Producer Distributor Services

Others:

Branch of activity:

Products:Materials:Others:

Ceramic tiles Frits Machinery

Trims/Third fire Ceramic pigments Engineering

Bricks Ceramic colours Architecture

Roofing tiles Clays and related materials Façades

Glass Ceramic additives Waste treatment

Ceramic sanitary ware Other ceramic sector raw materials Design

Tableware Spray-dried powder Ceramic artware

Refractories Chemicals Advanced ceramics

Food containers

Others:

Company situation

Mark with one or more crosses the company situation in the last and penultimate closed years.
Penultimate year 20 / Last year 20

Autonomous company:
Independent company or company with one or more minorcommercial associations(all below 25 %) with other companies:

Penultimate year Last year

Associate company:
If the participation with one or more commercial associations exceeds 25% but not 50 %:

Penultimate yearLast year

Names of the associated companies:

Linked company:
If the participation with one or more commercial associations exceeds 50 %:

PenultimateyearLast year

Case 1:The applying company draws up consolidated accounts or is included in the consolidated accountsof another linked company

Penultimate yearLast year

Names of the associated companies:

Case 2:The applying company or one or more linked companies do not draw up consolidated accounts or are not included by consolidation

Penultimate yearLast year

Names of the associated companies:

Datafor determining the company category

AWU(Annual work units = Equivalentto number of persons working full-time). Indicate a numerical value.

In the penultimate year: In the last year

Indicate the range of approved annual accounts according to the company situation considered in the foregoing section

Turnover (F= Turnover expressed in millions of euros)

In the penultimate year:F ≤ 2 2 < F ≤ 10 10 < F ≤ 50 F > 50

In the last year:F ≤ 2 2 < F ≤ 10 10 < F ≤ 50 F > 50

General balance sheet(B= Balance expressed in millions of euros)

In the penultimate year: B ≤ 2 2 < B ≤ 10 10 < B ≤ 43 B > 43

In the last year: B ≤ 2 2 < B ≤ 10 10 < B ≤ 43 B > 43

Method of payment

Cheque at 30 days Transfer at 30 days

Pursuant to the Public General Act of Parliament for the Protection of Personal Data, LOPD 15/1999, you are hereby informed that the data collected here will become part of a file belonging to the Instituto de Tecnología Cerámica - AICE (hereafter ITC), with VAT numberG-46271144 and address at Campus Universitario Riu Sec, Avda. Vicent Sos Baynat s/n 12006 Castellón,to be used in managing, administering, extending, improving, and customising our services, as well as in providing commercial information that may be of interest to you. Moreover, in compliance with Article 22 of Law 34/2002, of 11July, on information society services and e-commerce (LSSI-CE), ITC intends to e-mail you the commercial and advertising information that you may need or that may be of interest to you. You have the right freely to revoke at any time the consent given to the receipt of commercial communications. If you do not consent to receiving these commercial communications, please mark the following box: (_) I do not want to receive any commercial communications.

Please note that you are legally entitled to access, rectify, and cancel the information and to oppose any above use, either by writing to the central offices or bysending an e-mail to ,attaching a photocopy of your National Identity Card given the highly personal nature of the exercise of yourlegal rights.

In compliance with the principle of quality of personal data, laid down in Article 4 of the LOPD, the user is responsible for supplying true, exact, complete and updated information that responds truthfully to the user’s situation, as well as for updating this information if it changes by exercising the right to rectify this.

Instituto de Tecnología Cerámica
Campus Universitario Riu Sec. Av. Vicent Sos Baynat s/n.
12006 Castellón (Spain)
Phone: 34 964 34 24 24 Fax: 34 964 34 24 25
Please return completed to: Estela Marín
Contact persons: Carmina Leal; Susana Escudero / , on enerofebreromarzoabrilmayojuniojulioagostoseptiembreoctubrenoviembrediciembre
Name and signature of the person responsible and company stamp