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Name
email address
Position/Job Title
Company name
Company Website
Address
Town/City
Postcode
County
Country (if not UK)
Telephone Number
Fax
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Quantity Required
Lifting Capacity	Kg
Chain Falls	One Two
Lifting Height	Metres
Preferred Lifting Speed	m/min
Single or Dual Speed required?	Single Dual
Power Supply	V Ph Hz
Low Voltage 42V control pendant required?	Yes No
Control Cable Length (normally 1.2m less than lift height)	Metres
With/Without emergency stop	With emergency stop Without emergency stop
Suspension required
Eyebolt	Yes No
Top Hook	Yes No
Push Suspension	Yes No
Electric Travel Trolley	Yes No
If push/electric trolley required – please complete details below
Beam Size	mm
Travel speed	m/min
Brake Required	Yes No
FEM Group
Duty Cycle	Light Medium Heavy
Chain Container Required	Yes No
Usage	Indoor Outdoor
Special Protection Against Water Ingress Required	Yes No
Protection to IP
Budget
Delivery required by
Query or quote details
Special Features Required