Machine Quotation Request Form Page 1 of 3 Please complete the following form as thoroughly and accurately as possible to allow us to recommend the proper machine for your application. Just click on the SUBMIT FORM button when you are finished for an immediate response. (Please note: Fields proceeded by an "*" are required information)

*Name
*Company
*Title
*Address 1
Address 2
*City
*State/Province
*Zip/Postal Code
*Country
E-mail
*Phone
Fax
*How should we contact you?	Phone E-mail Fax Snail-Mail
*What type of business are you in?	Tire Manufacturing Technical Rubber Goods Custom Compounding OEM/Manufacturer

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*Mixer Model/Size
*Batch Weight	Lbs. k.g. @ SG
*Maximum Through-Put	Lbs./hr k.g./Hr @ SG
*Mixer Cycle Time	min.
Drop Temperature of Rubber	ºF ºC
*Input (to batchoff) Temperature	ºF ºC
*Desired Laydown Temperature	ºF ºC
*Ambient	ºF ºC
*Specific Gravity	nominal range
*Durometer	nominal range

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What Type of Process Equipment Do You Have?
Mill	Calender
TSR	Gear-Pump Strainer
Extruder	Mill Blender
Other
Fixed Speed	fpm mpm
Variable Speed Range	fpm mpm
Roll Diameter
Roll Width