Our goal is to be a reliable source for all of your fleet management needs. The more we know about you and your business, the better we are able to serve you. Please take a moment to fill out the following short form. We have been sure to keep it brief. We know you're busy and appreciate your time. You can also call us Toll-Free for answers or to talk to any of our industry experienced staff at 1-800-355-1300. A knowledgeable human being will reply to this form within 1 business day! Allied Tank can also be reached by U.S. Mail at our location in Pennsylvania. Please forward all mail correspondence to: Allied Tank Co. 2554 Industry Lane Norristown, PA 19403 Local Phone: 610-631-5240

Name (required) email Address (required) Company Name Position/Title Telephone Fax Machine Address City State Zip What type of business are you in? Oil Heat Delivery LP Gas Delivery HVAC Septic/restrooms Industrial Maintenance Building Maintenance Public Building Common Carrier Government Office How long have you been in business? 1-5 6-10 11-20 21-35 36-75 76-100 101+ Click Here How many employees do you have? 1-5 6-10 11-20 21-35 36-75 76-100 101-500 500-1000 1001-5000 5001-10,000 10,000+ Click Here How many vehicles are in you fleet? 1-5 6-10 11-20 21-35 36-75 76-100 101+ Click Here What equipment do you operate? Petroleum Tank Trucks LP Gas Bobtails Vacuum Equipment Petroleum Trailers 307 Code Equipment Refuse Removal Marina Equipment Towing Equipment Packaged Goods Handling Custom Specific Duty Equipment Solid Bulk Handling How soon do you see yourself making any equipment or parts purchases? Right now Within a month In the next 2 months In the next 6 months Next year In the next few years Click here What are your primary interests? (please select any that apply) Parts Service New Equipment Used Equipment The AllVac Vacuum Trailer Changeovers Vehicle Inspection Financing Tailored Business Technologies Fishing Ballet Do you consider us to be within the service range for your business? (We are located about 45 minutes north west of Philadelphia) Click Here Yes No When would you like us to contact you? Right Now Next Month In a few months or fill in a date and time that's best for you How may we contact you? (please select any that apply) Email Telephone Fax Mail Visit How did you find our website? Click Here Via Search Engine Direct Mail - Post Card Direct Mail - Flyer Magazine Ad Saw the Allied Blimp TV Ad During the Super Bowl Would you like us to contact you when we update the "Classic Tank truck Gallery" (about once month) Yes No Do you want us to contact you regularly with special pricing or new product announcements. Yes No Would you like receive email or other advertising from other businesses that we feel serve the needs of the bulk marketing community? Yes No Please use this space for specific questions and comments, we check our email daily and will reply quickly to any questions you have about our products and services. We are eager to have your comments about our website, please make suggestions.