DO YOU HAVE A MAGNETEK ACCOUNT? YesNo
COMPANY NAME
FIRST NAME
LAST NAME
EMAIL
PHONE NUMBER
COUNTRY Select One United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d’Ivoire Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong S.A.R., China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Viet Nam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
STATE/PROVINCE Select One Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
STATE Select One Aguascalientes Baja California Baja California Sur Campeche Chiapas Chihuahua Coahuila Colima Durango Guanajuato Guerrero Hidalgo Jalisco México Mexico, D.F. Michoacán Morelos Nayarit Nuevo León Oaxaca Puebla Querétaro Quintana Roo San Luis Potosí Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz Yucatán Zacatecas
POSTAL CODE
CUSTOMER NAME
RFQ #
QUOTE #
DATE REQUESTED
DATE DUE
APPLICATION DESCRIPTION
CRANE INFORMATION: Crane Class ABCDFMill Duty
CRANE INFORMATION: Service Factor (%)
CRANE INFORMATION: Crane Motion BridgeTrolleyHoistA HoistOther
CRANE INFORMATION: Operated By PendantRadioCabOther
CRANE INFORMATION: Location IndoorOutdoor
CRANE INFORMATION: Ambient Temperature Provide min. to max. range in F
CRANE INFORMATION: Operating Temperature Provide min. to max. range in F
CRANE DATA: Stops per Hour
CRANE DATA: Unloaded Crane Weight
CRANE DATA: Loaded Crane Weight
CRANE DATA: Max. Unloaded Crane Velocity (ft./min.)
CRANE DATA: Max. Loaded Crane Velocity (ft./min.)
CRANE DATA: Point of Control Cab OnlyCab/PendantCab/Radio Standard ControlCab/Radio Proportional ControlOther
MOTOR DATA: HP
MOTOR DATA: RPM
MOTOR DATA: Full Load Current
MOTOR DATA: Full Load Torque
MOTOR DATA: Frame Size
EXISTING BRAKE: Type
EXISTING BRAKE: Wheel Size
EXISTING BRAKE: Torque Rating
EXISTING BRAKE: Manufacturer
EXISTING BRAKE: Model Number
POWER: AC Voltage 230/3/60 VAC460/3/60 VAC575/3/60 VAC
POWER: DC Series 250 VDC
ELECTRICAL: "H" Insulation YesNo
ELECTRICAL: Limit Switch Quantity
ELECTRICAL: Time Delay (DC Only) On SetOn Release
ELECTRICAL: Brake Rectifier (DC Only) Constant PotentialForcing-Hoist Only
ELECTRICAL: Rectifier Enclosure Type 12Type 3RType 4
MECHANICAL: External Torque Spring YesNo (Thruster Brake Only)
MECHANICAL: Automatic Adjust YesNo (300M Only)
MECHANICAL: Time Delay Valve YesNo (Thruster Brake Only)
MECHANICAL: Manual Release YesNo (Details Required)
MECHANICAL: Manual Release Type LatchingSelf-Cancel
HYDRAULIC: Hydraulic Override Kit YesNo
HYDRAULIC: Manual Hydraulic System YesNoElectrical Bleed Kit
HYDRAULIC: Time Delay Valve YesNo (Electrical Hydraulic Replacement)
BRAKE WHEELS: Symmetrical Hub YesNo
BRAKE WHEELS: Offset Hub YesNo
BRAKE WHEELS: Rough Bore YesNo
BRAKE WHEELS: Finish Bore YesNo
BRAKE WHEELS: Brake Wheel Coupling YesNo
WILL YOU BE SUBMITTING A QUESTIONNAIRE FOR ANOTHER PRODUCT TO GO ALONG WITH THIS ONE? If yes, please share what other product questionnaire you will be submitting.
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