Flat/strip-Type Bellows - Quote Request Form

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PROTECTIVE COVERS
FLAT/STRIP-TYPE BELLOWS
|
QUOTE REQUEST FORM
Date
Address ____________________________________________
_______________________________________________________
Company Name
______________________________________
City ____________________________ State/Prov. __________
Contact
_____________________________________________
Country ____________________ Zip/Postal Code __________
Quantity
____________________________________________
Telephone ___________________ Fax ___________________
Email _______________________________________________
Please use this form to request a quote for a custom flat/strip-type bellows. Fill in as many specification values as possible. If measurement
units are different than the options shown, please specify unit of measure.
1. Application Information
New Design or Replacement Application:
New Design
Replacement
Cover Orientation:
Horizontal
Vertical
Cross Rail
Construction Preference:
Dynatect Recommendation
Heat-Sealed
Sewn
Sewn/Folded
Vulca-Seal®
2. Operation Information
Continuous (ambient) Temperature: ________
°F
°C
Intermittent Temperature Range: Min. ________ Max. ________
°F
°C
Frequency of Exposure: _____________________________ Distance from Heat Source (if applicable)*: _____________________________
Maximum Travel Speed*: _____________________ Movements/Day _____________________ Acceleration*: _____________________
*Please indicate unit of measurement for each value.
3. Environmental Information
Heat Exposure:
Weld Splatter
Hot Chips/Swarf
High Ambient Temperature (specify in “Operation Information” above)
Abrasion Exposure:
Metal Chips/Swarf
Wood Chips/Shavings
Light Particles/Dust
Other ____________________________
Chemical or Liquid Exposure:
Water
Moisture
Salt or Sea Spray
Petroleum/Hydrocarbons
Oils (non-petroleum)
Hydraulic Fluid (petroleum-based)
Hydraulic Fluid (phosphate ester-based)
Acid
Coolant
Cutting Fluid
Other (specify) ________________________________________
Contaminant Exposure Level:
Minimal
Occasional
Heavy
Miscellaneous:
UV/Ozone
Outdoors
Food-Grade/FDA
Laser Beam
Clean Room
Other (specify) __________________
Regulatory Compliance:
Standard _________________________
Bellows must be fire retardant (list standard to the left)
Application Notes: ____________________________________________________________________________________________________
4. Cover Support Channels
(Channels can be included upon request. It is recommended to provide a drawing.)
Will the cover operate within an existing channel?
Yes
No*
*Would you like us to provide channel supports?
Yes
No
Support Type:
Channel Material:
Aluminum
Steel
Stainless Steel
C-Channel
Z-Channel
Bellows
5. Cover Dimensions
Depth
“X”
(X) Bellows Fold Height: _____________ Cover Width: _____________
in
mm
6. Extended/Retracted/Travel Requirements
Specify extended and retracted length requirements, or indicate travel and we will advise
retracted length. (Extended length = retracted length + travel distance)
Outside
(standard)
Retracted Length: _____________ Travel Distance: _____________
Flange
Extended Length: _____________ Dimensions specified in:
in
mm
Inside
Bellows
Flange
Depth
“X”
7. End Style/Mounting
Extended
We can provide custom designed ends with mounting holes as specified per customer drawing.
Orders placed without holes specified are shipped blank, without bolt holes. Reference above
Retracted
diagram for inside/outside flange.
End 1:
End 2:
Outside Flange (standard)
Inside Flange
Outside Flange (standard)
Inside Flange
Options:
Plate
Hook & Loop Fastener
Options:
Plate
Hook & Loop Fastener
Other/Special (provide drawing)
Other/Special (provide drawing)
38
Phone: 262-786-1500 or 800-298-2066 | Fax: 262-786-3280 | Email: |

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