Coil Lifter Quote/Information Request

Coil Applications Lifter Info/Quote Request Form:

Please fill out the form below to the best of your ability. If you do not know the information for a section, or you feel it is not relevant please leave it blank. Not all fields on this form are relevant to every application.

- Is this a request for a: Quote or is it for Informational purposes?

- If this is a Quote request, what date do you require a quote by:

*Name:**	*Company:**
Address 1:
Address 2:
City:	State: Zip: -
Country:
Phone:	Fax:
*E-Mail:**
	* Denotes Required Field



A Inner Diameter	B Outer Diameter	C Coil Depth	Coil Weight

Coil Material:
Banded:	Yes No
	If Yes, How Many:
	Band Width:
Material Thickness:
Protective Material Used:	Yes No
	If Yes, Protective Material Thickness:
Surface Condition:
Coil Temperature:
Horizontal or Vertical Tilting:
Duty Cycle (Required if Tilting):
Overhead Suspension Type:
Load Travel Distance:
Height of Lift Required:
Electric or Air Power Available:
Additional Info:

Once you have completed as much of this form as possible please click on the submit button below. Your form will be submitted to one of our capable application engineers for processing and you will be contacted shortly.

ANVER Corporation
36 Parmenter Road
Hudson, MA 01749

Toll free:
Tel:
Fax:
Home Page:
E-mail:

800-654-3500 - US & Canada only
978-568-0221
978-568-1570
www.anver.com

ANVER Corp., 36 Parmenter Rd, Hudson, MA 01749 USA - Tel: 800-654-3500 - +1-978-568-0221 - Fax: +1-978-568-1570
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