If you require a quotation on multiple pieces of equipment with different specifications either:
A) Contact us directly by calling 770-449-8810.
B) Print the blank form multiple times, complete relevant sections and fax it to us at 770-416-8460.
C) Submit a separate form for each piece of equipment.

Full Name:
Title:
Company:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State:
Zip Code:
Country:
Phone:
Fax:
E-mail Address:
Application (Film, Sheet, etc.):
Information Required for Blender & Material Handling Quotations: Continuous Gravimetric Blender Guardian® Batch Blender
Quantity required with the following configuration:
Number of Elements Required:
Blender Operating Range:   Min  Max lb/hr kg/hr
How is the material currently blended?
Loading System Control Voltage:	24 VDC 110 VAC Other
Blender Mounting:	Extruder Throat Mezzanine Stand with Vacuum Pickup Box Other
Power Voltage:
Is a remote weighed downcomer required?	Yes   No
What is the headroom available?	feet meters
Options to be included:	Printer Alarm Panel Extrusion Control Vacuum Receivers only (no material handling) Full Material Handling System
Element    Recipe Percentage (Min/Max)   Material (Pellets, Powder or Regrind) Bulk Density Free Flowing (Y/N) High Temp Purge Port A B C D E F G H
Additional Blender Request Comments:
Maximum Horizontal Distance from Blender to Material Supply:	Feet   Meters
Maximum Vertical Distance from Blender to Material Supply:	Feet   Meters
Maximum number of 90 degree elbows on a material line:
Maximum Total Distance from Blender to Vacuum Pump:	Feet   Meters
Maximum number of 90 degree elbows on a vacuum line:
How is material currently handled?
Additional Material Handling Request Comments: