|
First Name
|
* |
|
Last Name
|
* |
|
Company
|
* |
|
Address
|
* |
|
City
|
* |
|
State
|
* Other |
|
Zip
|
* Other |
|
Country
|
|
- Area Code
- Phone x Extension
|
* 000-000-0000 X 000 |
|
Fax
|
000-000-0000 |
|
Email
|
* |
|
Quote
|
Units
/ Quantity |
|
Make
|
Doran, GSE, Detecto, etc. |
|
Model
|
465, 8000, 439, etc. |
|
Interface
|
- RS232
- RS232 TTL
- RS485
- Ethernet
- Wireless
- Device Net
- Profibus
- Modbus
|
|
Scale Type
|
- Bench (under 300 lb.)
- Floor ( 300 to 30,000 lb.)
- Truck
- Axle Load
- Aircraft
- Balance (precision or Top Pan)
- Portable (wheels or fortlift skids)
- Tank
- Hopper
- Other
|
|
Operation
|
- Weigh Only
- Weigh & Print a Label
- Weigh & Print Tape
- Weigh & Print a Ticket
- Interface with Computer
- Interface with PLC
|
- Capacity
- or
- Max. Weight Range
|
- Capacity (500,1000, 50000) lb. or
kg.
- Division or Graduation (1,0.1, .002, .0005,
etc) Readability
- Unit (lb, grams, oz, kilos,etc.)
|
|
Accuracy Requirement
|
% (1, 2, 5, .1, .01, .02, .05,etc.) |
|
Platform Size Needed
|
- " Length x
- " Width x
- " Height
- (48" x 48" X 3.5" etc.)
inches
|
- Overall
- Size
- Restrictions
|
- " Length x
- " Width x
- " Height
- (48" x 48" x 5.0" etc.)
inches
|
|
Power Requirements
|
- 115-120 VAC
- 220 VAC
- 12 VDC
- 24 VDC
- 48 VDC
- Battery Pack
|
|
Environment
|
- Dry
- Wet
- Washdown
- Dusty
- Hazardous
|
|
Need |
- Now
- 3 Months
- 6 Months
- 1 Year
|
|
Comments
|