FAX YOUR ORDER or INQUIRY TODAY
Order Form
After An Order Is Processed . . .
How to Obtain an 800# for Quoting
ORDER/QUOTE FORM
INFO NEEDED
This is an order
Inquiry for Quotation
Date
Company Name
Account#
if available
Email Address (required)
Address
City/State/Zip
Contact
Phone
Fax
Please send me a:
Free Brochure
1. MBI part # if available
2. The belt width in inches
3. The belt length in feet
4. Type of product being conveyed
5. Conveying Bed Type
Slider Bed
Flat Rollers
Troughed / Degree of Trough
6. Splice Type
Butt Ends
Prepared Ends
Laced
Other
Endless / Type
7. Pulley Sizes
Head Pulley Diameter
Tail Pulley Diameter
Snub Pulley Diameter
8. Belt Speed F.P.M
Motor H.P
.
9. What type of Take-Up pulley is used
10. Any problems that resulted in a replacement or premature failure
11.
Other Information that may be needed for fabrication on the bel
t
Cleat Height
V Guide Type
Cleat Width
V Guide Location
Cleat Centers
Cleat Styles
Other Special Needs
For Hole Punch, Perforated, Sidewall or Weldwall: Please check the box and we will fax you a separate specification sheet.
Website: www.mulhernbelting.com
East: 800-253-6300 Central: 800-444-2358
