| Date
Bid is Due By: |
|
| Company
Name: |
|
| Address: |
|
| City:
|
State:
ZIP:
|
| Contact
Person: |
|
| Business
Phone: |
|
| Business
Fax: |
|
| Cell
Phone: |
|
| Email
Address: |
|
| Estimated
Periodic Inspection Date: |
|
| #
of JIB Hoists: |
# of Drives:
Tonnage:
|
| #
of Bridge Hoists: |
# of Drives:
Tonnage:
|
| #
of Monorail Hoists: |
# of Drives:
Tonnage:
|
| #
of Gantry (A-Frame): |
# of Drives:
Tonnage:
|
| #
of Spare Hoists: |
# of Spare Slings:
#
of Safety Harnesses:
|
| #
of Auto Lifts: |
# of Jacks:
#
of Aerial Lifts:
|
| #
of Batting Cages: |
# of Gym Curtains:
#
of Basketball Hoops:
|
| #
of Wrestling Mat Lifters: |
Height to Reach Items to be Inspected:
|
| If
Inspection Height is Over 10', do You have a Lift
We Can Use?
|
| If
Large # of Hoists, Do You Have a List That Could
be Sent via FAX or Email?
|
| How
Did You Hear About Us?
|
| Additional
Comments: |
|
|
|
