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HGAPS - Asset Analysis   In order to receive a confidential Asset Analysis from Harrington Group, please complete the following form. Please note that all items marked with a red asterisk * are required to process this form.     *Name (first/last): * * *Company: * *Address (line 1): * Address (line 2): *City: * *State/Province: * *Zip/Postal Code: * *Country: * *Telephone: * Fax: *Email Address: *     Section 1: General Returnable and Reusable Asset Assumptions   Type of Asset : --------------- Select ---------------- Dairy Crates Dairy Plastic Pallets Dairy Wood Pallets Dairy Load Bars Dairy Racks Dairy Totes Dairy Hand Trucks Dairy Bossy Carts Bakery Crates Bakery Roll Trays Bakery Multi-Level Trays Bakery Double-Level Baskets Bakery Single-Level Baskets Bakery Bread Baskets Bakery Peel Boards Bakery Rackable Pallet Trays Bakery Dollies Bakery Carts Beverage Crates Beverage Pallets Beverage Can Trays Beverage Merchandiser Crates Beverage Castle Crates Beverage Wave Crates Beverage Bag-in-Box Totes Beverage Beer Kegs Current asset float size: (Enter number of assets) Years to replace current float: (Number of Years) -Select- 1 year` 2 years 3 years Average annual growth rate: (Enter %) Average annual inflation factor: (Enter %) Marginal corporate tax rate (National & local): (Enter %) Depreciation period for capital expenses: (Enter number of years) -Select- 5 years 7 years 10 years   Section 2: Returnable and Reusable Asset Assumptions   Market value of existing assets: (Enter $/asset) Delivered cost of new replacement assets: (Enter $/asset) Percentage of assets lost per year (including disposal and lost in trade): (Enter %) Asset expenses including new purchases, outside or internal costs, etc.: (Enter total $) Cost to operations caused by damaged assets including down time, re-stacking, and product damage: (Enter total $)   Section 3: Returnable and Reusable Asset Assessment   How many assets do you manage? --Select One-- 1,000 or less 1,000 to 5,000 5,000 to 10,000 10,000 or more Do you assign assets to individual employees or cost centers? ---Select--- Yes No Sometimes Do your assets move regularly within or between facilities? ---Select--- Yes No Sometimes Do you reuse existing assets as they become available? ---Select-- Yes No Sometimes Is significant time spent searching for assets to reuse? ---Select--- Yes No Sometimes When was the last occasion that actual assets were reconciled to financial asset ledgers? ---Select--- 1-3 years ago 2-5 years ago More than 5 years ago Never Are you covered by compliance regulations? (GASB 34, Sarbanes-Oxley, Federal, etc.) ---Select--- Yes No How do you track the whereabouts of your assets? ---Seclect-- Not tracked Manually Spreadsheet Home grown system Purchased system How do you maintain asset accounting records? ---Seclect-- Not tracked Manually Spreadsheet Home grown system Purchased system Are your assets tagged? ---Select--- Yes No How many departments track assets? ---Seclect--- None 1 2-3 4 or more How many customers, distributors, vendors, and suppliers track assets? ---Seclect--- None 1 2-3 4 or more   Section 4: Additional Information   Please advise us on any additional information you feel would be helpful.

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