AMS Filling Systems - RFQ Form

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Required Fields are in red.

Date:
Company:
Contact:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Cell:
	A	B	C
Product Name:
Density:
Dusty:
Aerates:
Hygroscopic:
Hazardous:
Other:
Container Type: (Bag, Bottle, Can, Jar,drum,carton, bag-n-box,other)
Dimensions:
Length:
Width:
Height:
Opening:
Fill Size/Weight:
Speed (rate/min.):
Desired Accuracy:
How is product to be fed to filler?
Voltage required?
Line Height required?
Nozzle Height required?
Air Available?
Washdown?
Comments?