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Request for Quotation

Company /
Organization:
Name:
Address:
City:
State/Province:
Zip Code /
Postal Code:
Country:
Date: (MM/DD/YYYY)
Main Phone Number:
Fax Number:
Email:
Customer Ref Quote#:
Part Name or Number(s):
Part Description: Enter a two or three line description of your desired part
Description of Final Orientation:
Actual Rate Per Track: /Min.
Bowl Rotation: CCW CW Unspecified
Part-Size(s): Total Parts:
Dry:
Oily:
Part Style(s):
Air Allowed:NO YES Unspecified
To Be Submitted to HEI with in 7-10 days:
Part Prints: NO YES Unspecified
Part Samples: NO YES Unspecified
Bowl / ITEMS TO QUOTE Quantity
Feeder (Vibratory)
Feeder (Centrifugal)
Customer Sound Specification: dB(A)
Sound Dampening (Filled Dual Bottom):NO YES Unspecified
Sound Dampening (Filled Skirted Area):NO YES Unspecified
Bowl Coating NO YES Unspecified
Coating Type   
Sound Enclosure w/ Additional Plate Size: NO YES Unspecified
Optional "Quick Dump" in Bowl: NO YES Unspecified
Back Pressure Relief in Bowl: NO YES Unspecified
External Shut Off: NO YES Unspecified
Blow Off: NO YES Unspecified
Hardened Steel Selectors:NO YES Unspecified
Hardened Steel Discharge:NO YES Unspecified
Track - ITEMS TO QUOTE Quantity
Gravity
Tracks		 " Straight, Down ºAngle Gravity Track
" Vert. DischargeGravity Track
" Horiz. DischargeGravity Track
Horizontal
Tracks		 Drive | Solid Mtl. | w/ " Track
Belted Conveyor Track " Long
"Dead" Receiver Block:NO YES Unspecified
Prefeeder - ITEMS TO QUOTE
Storage Hopper:NO YES Unspecified
Cubic Feet:      Style:  
Hopper/Elevator:NO YES Unspecified
Cubic Feet:  
Cleated Belt: NO YES Unspecified
Hopper Coating: NO YES Unspecified
Hopper Lining: NO YES Unspecified
Optional "Quick Dump" in Hopper: NO YES Unspecified
Blanchard Ground Base Plate: NO YES Unspecified
Thickness: "
Square Tubular Frame: NO YES Unspecified
Tube Size: "
Single Column Pedestal: NO YES Unspecified
Distance from the mounting surface to the output Running Surface: "
Additional - ITEMS TO QUOTE
Electrical Voltage - 110 VAC 220 VAC 50 Hz 60 Hz
Nema Electrical Enclosure: NO YES Unspecified
Style: 
Paint Color PRIMER- GREEN- GREY- BLUE Other
Customer Specification
Mechanism(Describe Function):
What Do Parts Exit Into?
Please enter any additional information below:



©2006 Hendricks Engineering Inc.
Phone: 317.546.2243 • Fax: 317.542.9732 • Email: sales@hendrickseng.com