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Expression of interest (EU-Countries)
General Information
Company name
*
VAT number
*
Complete address
*
Country-Region
*
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (the Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Website
Company Logo
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Contact Person
Name Surname
*
Role
*
E-mail address
Phone - Mobile Phone
*
Added Information
Company dimension
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Micro
Small
Medium
Large
Year of foundation
N. employees (last year)
N. turnover (last year)
Manufacturing Category
Indicate the present manufacturing category which the company belongs to
*
Mechanical
Textile
Distillers and liqueurs
Cosmetics
Healthcare
ICT sector
Please indicate the products that the Company offers linked to COVID19 emergency
Mechanical and other manufacturing sectors (Plastic sector, etc.)
Lung ventilators
Mechanical components for health care products (such as for lung ventilators)
Antibacterial gel dispenser environments
Disposable glove holder suitable for indoor and outdoor
Respirators
Hands free doors openers
Aerosol box
Gloves, Examination gloves
Face mask 3d printed, injection molded
Ear savers and nose bridge supports
Face shields
Other, please specify
Other, please specify
Textile
Medical clothes
Protective gowns
Face masks
Suits Scrubs
Shoe covers
Other, please specify
Other, please specify
Distiller
Alcoholic solutions and disinfectants for personal use
Alcoholic solutions and disinfectants for environments
Other, please specify
Other, please specify
Cosmetic
Hygiene, disinfectants and detergents
Other, please specify
Other, please specify
ICT& DIGITAL SERVICES
Innovative telemedicine software and solutions
HEALTHCARE
Medical solution connected to COVID-19 needs
Other, none priority
Brief Description of the Company (sector/target market/main products-services)
*
Strengths and innovation of your compaby/products. If your offer have quality standards
Description of the company success story (Ex: innovative solutions offered linked to Covid19 emergency, reconversion of production case, etc.)
Main current foreign markets
Does the company currently operate on foreign markets?
*
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Yes
No
Collaboration's fields of interest
Please specify the kind of collaboration required
*
Purchase
Sales
Subcontracting agreements
Manufacturing agreements
Joint venture
Know-how
Technology transfer
R&S
Representation agreements
Licenses
Other
In reference to Project Purpose, are you mainly interested in:
*
Interested in finding new collaborations (such as joint ventures, manufacturing agreements)
Interested in showing best practice, initiatives
Training activity - deepen the topic of Production Reconversion, Innovative Solutions in Health Care sector, etc.
The company declares:
To be
established
in the
following Countries
: Czech Republic, Italy, Poland and Slovakia;
To be
active
in one of the
target sectors
indicated in the Application Form;
To be
active
, not in
liquidation
or
bankruptcy
and not have been subject of bankruptcy proceedings or in the pre-settlement procedure;
Not be in receipt of an
outstanding recovery order
following a European Commission decision declaring the aid received illegal and incompatible with the common market;
Fulfill obligations
related to payment of tax liabilities and liabilities for pension and health insurance in accordance with the legal provisions in the applicant’s Country;
Comply with the rules concerning accidents at work and occupational diseases, safety in the workplaces, the collective labor agreements and regulations relating to environmental protection, in accordance with the legal provisions in the applicant’s Country;
Consent that its
data
and
information
indicated in the Application Form, will be published in the
PPE HEALTH PORTAL website
, that is
open
and
fully visible
without restrictions, and shared between Third Parties and Project Partner for exclusive achievements of project objectives. The publication on the portal guarantees visibility and potential contacts with purchasing bodies and manufacturing companies.
DISCLOSURE REFERRED TO IN ART. 13 of Law 196/2003 According to the above provisions we inform you that the personal data collected in relation to the relationships established may be the subject of the processing referred to in Law 196 / 2003. Data are held on the basis of legal and contractual obligations, the Company does not need the consent of the interested party to perform the treatment. Article 7 grants the interested Party the exercise of specific rights, among which the interested Party can request the modification or cancellation of its own data with a specific communication addressed to our company.