PNEU-CON REQUEST FOR QUOTE FORM

Rep Name:

CUSTOMER INFORMATION

An asterisk* indicates required information - you must complete these fields before submitting your form.

*First Name: *Address:
*Last Name: Suite / Floor :
*Company: *City:
*Phone: *ST: Province: 
*Email: *Postal Code:
Fax: Country: 

MATERIAL CHARACTERISTICS

Name of Material(s) Conveying Rate Bulk Density
lbs. per hr lbs. per cu ft

Characteristics: Other Information:
Material Description:
NOTE: Unknown materials will require a 6 fluid oz. sample to be sent to Pneu-Con.

PROCESS INFORMATION

Conveying Distances:

Plant site elevation and location:

Overhead room (cranes or other overhead equipment):

Size of largest shop door:

Other information:

Vertical - Horizontal -
No. of Elbows in material conveying line:
No. of Machines to be conveyed to:
Will there be a common material line?

 

Material Supply Information
(silo, gaylord, bag dump, etc.):
Material Contact:
 

Enter ASSC here before submitting RFQ (*required):