Customer Information |
| Contact Name |
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| Company Name |
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| Address * |
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| City, State, Zip * |
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| Phone * |
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| Mobile |
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| Fax |
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| E-mail * |
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| Web Site |
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| Type of Business |
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| Personal Information |
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Palletizing |
Machine Specifications |
| Machine Model Designation |
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| Quantity |
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| Hand |
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| Configuration Plate No |
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| Figure No |
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| Electrical Specifications |
Volts:
Cycle:
Phase:
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| Air Supply |
CFM:
PSI:
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| Speed (Max) Per Minute |
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| How many stacking patterns are required? |
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| No. of stack height selections |
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| Max stack height selection (Incl. Pallet) |
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| Weight of heaviest pallet load (Incl. Pallet) |
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| Paint |
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| Pallet Magazine |
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| Production Infeed |
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| Palletizer Discharge Conveyor: (Power for 1 load included) |
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| Length of Depalletizer Infeed Chain Conveyor |
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| Special features or requirements |
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| Type of programmable controller |
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| Other Information |
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Infeed Belt Conveyors |
| Indicate infeed belt conveyor to be furnished with this machine |
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| Width (Inside Rails) of existing case conveyors |
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| Type |
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| Elevation case conveyor connects to palletizer infeed belt conveyor |
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| Decaser infeed elevation |
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| Will you be supplying case conveyor with order? |
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Misc. Plant Data |
| Headroom at machine location |
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Minimum door opening to machine location:
(Note: Be sure to check dock heights, door
heights, R.R. sidings, ceilings, pipes, roof trusses, sprinkler
headers, etc. to be sure equipment can be moved into place
upon arrival. Please advise of any unusual conditions.)
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| Are there any palletizers in this plant? |
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| Is this a new plant installation? |
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| Is this a new conveyor system? |
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| Has a layout drawing been made? |
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| Approximate delivery required? |
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| Do you have any other quotations? |
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Current Equipment |
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* Note: 1 or 3 headed Dismantler |
| Do you wish to use these in the overall solution or do you wish to sell any of this equipment? |
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Closing Questions |
| What is your timeframe for implementation? |
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| What is your project budget? |
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| Do you have any other quotes? If so, how much and from whom? |
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| Are you the sole decision maker? |
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| What criteria will you use in your decision making process? |
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