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Congratulations, you are now entered the selection process as a candidate to represent or distribute Horizon products in your country. In order to move our selection process forward, please fill out the following form completely and diligently and send back by email as soon as possible. We look forward to your response. 1. Why do you believe you are ideally sui ed o be!o"e a #ori$o% re&rese% a ive or dis ribu or' ( !!"#!! words$ (. Wha are your a%%ual reve%ues i% USD' ). #o* "a%y e"&loyees do you have' (a) less than 25 (b) 25 -100 (c) 100 and up +. Do you have a% es ablished sales %e *or,' (a) no (b) yes, if so please describe this network ( !! words$ -. .a% you &rovide R/D a%d e!h%i!al su&&or !a&abili y i% 0uel !ell / 0uel !ell1i% e2ra ed &rodu! s' (a) Yes I have a lab and technicians able to troubleshoot fuel cells and provide hydrogen supply services (b) I can acquire the required fuel cell laboratory capability (c) I don t plan to have this capability 3. Wha y&e o0 &rodu! 4s5 do you !urre% ly sell' 4you !a% !hoose several 0ro" he lis belo*5 (a) !oy "roducts (b) #ducational "roducts (c) $obby %& "roducts (d) "ortable "o'er (enerators (e) %ecreational ) *arine "roducts (f) +tandby "o'er ) ,ac--up "o'er +yste.s (g) %ene'able energy products

(g) /ight #lectric 0ehicles (h) & #lectronics (i) 1ll of the above (2) 3ther4555555555555555555555555555555 6. Wha *ould you say is/4are5 your !ore ar2e "ar,e 4s5' 7ou !a% !hoose several belo*8 (a) !oys-%& hobby retail (b) +chools for education)discovery -its (c) & electronics (d) %ecreation)*arine (e) !eleco. (f) 6niversities (g) (overn.ent (h) 7efense)1erospace (i) !ransportation (2) 1ll of the above (-) 3ther4555555555555555555555555555555

9. Wha is your e:is i%2 e:&er ise i% er"s o0 sales !ha%%els' (a) product to retail sales (b) industrial ) b2b sales (c) govern.ent sales (d) %87)university sales (e) 3ther555555555555555555555555555555555 ;. Are you !urre% ly re&rese% i%2 o her "a%u0a! urers or &rodu! li%es' (a) no I do not represent any brands no' (b) yes9999if so 'hich products)brands are you representing:

1<. Do you already have de"a%d 0or s&e!i0i!ally 0or o%e or all o0 #ori$o%=s e:is i%2 &rodu! s 0ro" e:is i%2 !lie% s' Do you have de"a%d 0or 0uel !ell &rodu! s i% 2e%eral' Please e:&lai%. ( !!"#!! words$

11. Whi!h #ori$o% &rodu! s do you believe you !a% sell bes 4based o% &rese% e:&erie%!e/!a&abili ies5

(a) !oys and educational -its such as $-racer, $ydrocar, %ene'able #nergy #ducation +et etc; (b) *odel $obby %& products (c) (d) (d) (e) *inipa- handheld fuel cell 6+, po'er supply +unbo< 6+, ) +olar light and charger $ydropa- 50= portable po'er 120 7& supply %87 products (>uel cell stac-s, peripherals, hydrogen storage)

(f) 1ll of the above (g) 3ther455555555555555555555555555

1(. I0 you i!,ed >All o0 he above> i% ?ues io%s -. 3. 6. or ;. &lease hel& us u%ders a%d ho* you are able o serve all hese di00ere% se2"e% s : ( !!"%!! words$

1). Wha *ould be he a% i!i&a ed volu"e/reve%ue 0or sele! ed #ori$o% &rodu! s i% your !ou% ry 4&lease s&e!i0y5 duri%2 he 0irs year'

1+. Will you be ready o !o""i year'

o a "i%i"u" order ?ua% i y i% he 0irs

1-. Please &rovide a% overvie* o0 your &la%%ed !o""er!ial s ra e2y 0or 4sele! ed5 &rodu! s (100-200 'ords) 13. #o* did you 0i%d ou abou #ori$o% @uel .ell Te!h%olo2ies'