Date:

Time:

Sales Engineer:

Organization:

Phone Number:

Fax Number:

Email Address:

Return Quote to Rep?:

YesNo

Return Quote to Customer?:

YesNo

Company Name:

Contact Name:

Title:

Address:

City:

State:

Zip Code:

Telephone:

Fax Number:

Email Address:

Competition Quoting?:

YesNo

If Yes, Who?:

How Competitive?:

Extremely
Close (10%)
Not an Issue

Probability of Getting Order?:

100%
75%
50%
25%
Less

Quoted Previously?:

YesNo

What is Drawing/Quote Number?:

Application/Project Name:

Estimated Purchase Date?:

Quantity to be Quoted:

How to Quote?:

Bulk
As Kit (Cut,Drill,Tapped)
Full-Assembled
Both

Return Quotation By?:

Other Vendors Considered?:

YesNo

If Yes, Who?:

Integrator Preferred:

Weight of Part Including Fixture:

Workpiece Carrier, Rotate:

YesNo

If Yes:

MultidirectionalUnidirectional

Speed (Meter/Min) TLM 1000:

12
15
19

Speed (Meter/Min) TLM 2000:

9
15
19

Variable Speed:

Antistatic?:

YesNo

Voltage:

120V 1PH
220V 3PH
440V 3PH

Customer Specify Components:

YesNo

Details:

item Specify Components:

YesNo

Details:

Integrator Specify Components:

YesNo

Details:

Enclosure Guarding Needed:

YesNo

Details:

Automation Cells Needed:

YesNo

Details:

Workstations Needed:

YesNo

Details:

Parts Flow System Needed:

YesNo

Details: