Multi-Vac Proposal Request Form

Company Information
Company:
Proposal Due Date:
Address:
Telephone No.:
City:
State:
Zip Code:
Country:
Fax No.:
Name:
Title:
E-Mail:
Copy To:
Title:
Project Name:
1. Application
Application:
Unit of Measures:
2. Process
Describe your process
3. Materials To Be Conveyed
Materials To Be Conveyed:
Avg. Particle Size:
Max. Particle Size:
Bulk Wt.:	Lbs./Cu. Ft
Material Degradation a Concern?	Yes No
Moisture Content as a %:
Probe Required:
Characteristics of material:	dry wet hot sticky fibrous abrasive electrostatic acid oily
Maximum Material Temperature:
4. Conveying Rate
Required Conveying Rate per hour	Please Specify Units(tons, liters, gallons etc...)
Max. Conveying Distance:
Horizontal:
Vertical:
No. of Turns
5. Hose Diameter
Preferred Hose Dia.:
Elevation of Jobsite:	feet above sea level
6. Questions for Fixed Manifold System
Piping Required:	Yes No
Piping Layout Attached:	Yes No
Multi-Vac To	size pipe supply pipe install pipe
Total Number of Pick Up Points:
Total Number of Drop Points:
Number of operators at same time:
Silo/Bin/Bunker:
7. Electrical
Electrical Service:	Please Specify Volts, Phase, Hertz
Explosion Proof NEMA Classification:
Powered By:
Compressed Air Available:	Yes No
psi:
8. Hopper System
Description of Hopper System Required
Product Discharges:
Other Type of System, please describe:
What happens to material after it is collected:
Vacuum Power Pack located:
Similar To Model or Photograph No.:
Add any details we should be aware of:
9. Vacuum
Vacuum to be Towable:	Yes No
Towable:
Ground Clearance:
10. HEPA Filtration
HEPA Filtration:	Yes No
Noise Specification:	Yes No
Required Decibels @ 3 feet:
11. Surface Preparation
Special Surface Preparation:	Yes No
Specification:
12. Paint
Special Paint Required:	Yes No
Specification:
13. Special Features
Intercept Hopper:
14. Specifications
Specifications Required:
15. Base Price Special Equipment
Special Equipment To Be Included In Base Price:
16. Optional Special Equipment
Special Equipment To Be Included As Optional Items:
17. Delivery Requirements
Shipping, Unloading, and Installation Considerations:
Smallest opening equipment passes through:	Please Specify wide x high
Headroom limitations:
Floor load limitations:
Floor space limitations:	Please Specify wide x deep
18. Purchase Time Frame
Please indicate a purchase time frame for this application:
19. How did you find us?
Please advise how you found us: