TECHNICAL QUOTE FORM

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Please use this form if you DON'T KNOW what your looking for!
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Title: Mr. Mrs. Ms. Miss Name:
Company Name: Title:
Phone: Area code + number Fax:
E-mail: Country:
Please fill out as much information as you can below or if you would like 
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Wheel Requirements:
 Wheel Diameter: Tread width: Wheel Material     
 If you don't know what material you need, please check this box
and explain your floor conditions in detail here:
Caster Requirements:
Swivel / Qty: Rigid / Qty: Swivel/brake /Qty:
  Round stem Hollow king pin Expanding stem Pipe thread Scaffold stem
 I need Each Caster to carry at leasteach.
Tread brake (brakes wheel from top) Direction lock (locks swivel only)
other/(explain)
 Shock absorbing Dual wheel Stainless Steel
High-temperature 2 pos. swivel lock 4 pos. swivel lock Non-corrosive
 fully sealed for clean rooms NSF approved
other please explain: