Cart Mover Application FormClick here to download and complete the PDF version of the form. Step 1 of 7 14% Quotation Type* Budgetary (Project Funding)Firm (Funded Project) Customer Information Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Name* First Last Email* Phone* Cart Specifications Please Indicate What Unit of Measures You Intend on Using Within This Form* lb kg in cm N Max Load Weight* Is the Load to be Moved On* CastersRailsOther What is the Wheel Configuration?* 2x Fixed, 2x Swivel4x Swivel4x Swivel with Directional Lock2x Fixed Casters, 2 Support Legs4x Fixed1x Swivel, 2x Fixed, 1x Swivel2x Swivel, 2x Fixed, 2x SwivelOther. Please attach photo. Please Upload an Image of the Connection Point Drop files here or Will the Machine Need to Travel Up or Down any Slopes with a Load?* YesNo Where will the Machine be Used?* InsideOutsideBoth Do You Require a Stainless Steel Machine?* YesNo Will the Machine be Operating in an Explosive or Potentially Explosive Environment?* YesNo What Do You Want to Improve?* EfficiencySafety Comments Environment Are Any of the Following Applicable for Your Environment?* Temperature Explosive Radiation Ingress Protection Clean Room Stainless Steel Other Will the Machine Need to Travel Up or Down any Slopes With a Load?* YesNo Please Provide the Degree Angle or Dimensions of the Slope* Will the Machine Need to Travel Up or Down any Slopes Without a Load?* YesNo Please Provide the Degree Angle or Dimensions of the Slope* Will the Floor Be* Clean Wet Dusty Greasy/Oily Other Will the Machine Need to Move Over Obstacles?* YesNo Which Obstacles?* Curbs Speed Bumps Raised Rails Recessed Rail/Gaps in Floor Other Please Note the Size of the Obstacles* Please state the name of the obstacle, height/depth and width in inches. Where Will the Machine Be Used?* Inside Outside Comments Usage How is the Load to be Moved?* Push Pull Steer What is the Approximate Distance Travelled Per Move With the Load?* What is the Approximate Distance Travelled Per Move Without the Load?* How Many Days in a Week will the Machine be Used?* How Many Shifts are there Per 24 Hours?* How Many Times Per Shift will the Machine be Used?* How Many Times Per Hour will the Machine be Used?* When can the Machine be Charged?* 2-10 Times per ShiftOvernight How Long can the Battery be Charged During These Periods?* 10-20 Min61-150 Min21-60 MinOvernight Comments Trolley Overview Does the Trolley Exist?* YesNo Is the Trolley Designed?* YesNo Do you Require Advice on a Trolley Design?* YesNo How Many Trolleys Do You Have?* How Many Different Trolley Types Require Moving?* If you have multiple trolley types we will require details for each type. How Many Trolleys Require Moving at Once?* Can we Attach a Standard Female Coupling?* YesNo Comments Trolley Details Dimensions of the Load* L x W x H Height of Load* Distance Between Casters Rotated in* Is There an Overhang, If So What Size Is It?* L x H Are There any Obstructions on the Underside of the Trolley?* YesNo If Yes, Please Provide the Dimensions of the Obstruction* L x W x H Wheel Material* PolyurethaneNylonSteelRailsRubber (Pneumatic)Other Wheel Condition* New/Nearly NewModerately WornWornPoor Wheel Condition Notes* Notes on Load* What Are You Connecting To?* Square Rectangle Angle I-Beam U-Channel Round Half-Round Other (Please Attach Photo) File Drop files here or If Connecting to the Square or Rectangle Please Provide Dimensions* L x W x H Is There Unrestricted Access to the Connection Point?* YesNo Load Testing: Stain Read 1* Load Testing: Stain Read 2* Load Testing: Stain Read 3* Load Testing: Stain Read 4* Load Testing: Stain Read 5* Comments Additional Information Comments File Drop files here or CAPTCHA Name This field is for validation purposes and should be left unchanged.
