Datos Cliente

Compañia:
Date:
Persona de Contacto:
Cargo:
Dirección:
Ciudad, Provincia:
País:
Código Postal:
Teléfono:
Fax:
Email:

A =
B =
C =
D =
E =
F =
G =
H =

Machine Type:
Machine Manufacturer:
Model:
Location of Bowed Roller (where in the process)?:

Max Web Speed: fpm
Average Web Speed: fpm
Web Material: Board Paper Film Foil Other
If other, specify:
Web Thickness / Weight:
Web Tension: pli
Operating Temperature: °F
Bow Type:    Fixed Bow       Variable Bow
Mounting Type:       Foot      Flange
Covering:      Rubber (Std.)      Other
            If other, please specify:
Driven?:       Yes      No
            If yes,     Flat Belt       V Belt   Other
            If yes, how is it driven (pulley, pulley type, etc.):
If there is a presence of water, chemicals, solvents, grease, etc., please specify:

Other comments or information:

Please send drawing of bowed roller if available
(email to info@doubleeint.com.mx or fax to 5255 5511 9331).