Contact Person:*
Customer Name*
Phone No:*
Fax No:
Email*
Address:*
Product Required and Application Information (Operating conditions)
What do you want to buy from Product range: V/Belts, Coupling, Clutch, Chain Drive, Speed Reducer, Variable Speed, Conveyor Belt
Product/s:*
What is it for: (Pump drive, Conveyor drive, Truck mixer, Crusher, Compressor etc)
Application:*
Driving Machine: (Electric motor, Diesel engine, Petrol engine, number of cylinders
Driver:*
Driven Machine (Pump, Conveyor, Fan, Compressor, including type – reciprocating, centrifugal etc)
Driven:*
Normal Operation (Pump drive, Conveyor drive, Truck mixer, Crusher, Compressor etc)
Example: …………… hrs / day …………… days / yr ……………… starts / hour
Duty Cycle:*
On Drive Components
Load:
Uniform
Moderate Shock
Heavy Shock
Security Code:
