Quote Request Form Step 1 of 3 33% Customer InformationCompany Name* Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact Name* Email* Confirmation Email If you would like a copy of your submission please enter your email address here.PhoneFax Part InformationPart Name Part # / Drawing # Part PrintNoYesPart ConditionCleanDryOilyPowdered# of Part Sizes # of Part Styles Feed Rate (PPM) Part Orientation System Information# of Systems Required Type of Feed SystemVibratoryCentrifugalOtherBowl RotationClockwiseCounter-ClockwiseTBDAir AllowedYesNoBowl Material304 Stainless Steel316L Stainless SteelOtherFill and GrindNoYesBowl CoatingNoYesLexan Cover on BowlNoYesLinear TrackingNoneVibratoryConveyorAir TrackGravity TrackTubingOtherLength Down Angle Dead NestNoYesBulk Storage HopperNoYesHopper Run Time (Hours) Hopper CoatingNoYesHopper Lexan CoverNoYesElevatorNoYesSound EnclosureNoYesMounting PlateNoYesMounting Plate - Requested Size Table FrameworkNoYesPart Running Surface Height (From Floor) Electrical Power120 VAC240 VAC480 VACHZ6050PhaseSingleThreePaint Color MechanismNoneEscapementPick & PlaceVision SystemCross ShuttleBlow FeedLinear PositionerotherMechanism DescriptionPart Print- File Upload (8 MB max file size)Accepted file types: pdf, jpg, dwg, png, jpeg, Max. file size: 8 MB.Part Orientation - DescriptionTop View of Part - File Upload (8 MB max file size)Accepted file types: pdf, jpg, dwg, png, jpeg, Max. file size: 8 MB.Side View of Part - File Upload (8 MB max file size)Accepted file types: pdf, jpg, dwg, png, jpeg, Max. file size: 8 MB.Additional NotesUntitled
