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Company name:

Province/State:

Contact name:

Postal/ZIP code:

Email address:

Phone number:

Address:

Fax number:

City:

Job reference#:

Equipment Type

T/R D/G Bridge Crane
T/R S/G Bridge Crane
U/R S/G Bridge Crane
Jib Crane

D/G Trolley Hoist
S/G Trolley Hoist
Monorail Trolley Hoist
Radio Control Unit

D/G Gantry Crane
S/G Gantry Crane
Chain Hoist
Other

Main Hoist

Lifting capacity:

Lift height:

Lift speeds:

Single Speed
Two Speed
VFD

Trolley speeds:

Single Speed
Two Speed
VFD

Auxiliary Hoist (If Applicable)

Lifting capacity:

Lift height:

Lift speeds:

Single Speed
Two Speed
VFD

Trolley speeds:

Single Speed
Two Speed
VFD

Bridge (If Applicable)

Capacity:

Span:

Other

Control

Power Supply Enclosures

Pendant on track
Pendant from hoist
Radio Control w/ pendant back-up

CEMA 1
CEMA 2
CEMA 4

Runway

Do you require a runway system for this equipment?
  Yes
  No

If yes, please check all the components you require:
  Conductor
  Beams
  Columns
  Rail

What is the required length of the runway?

If new columns are required, will they be:
  free standing
  tied back to existing structure

What is or what will be the down shop center to center spacing between them?

Do you require installation of this equipment?
  Yes
  No

Do you require freight to the job site? (If yes, what is the location?)