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Customer Information Company Name: Submitted By: Address: Title: City, State, Zip: Phone Number: Country: Fax Number: I.T. Equipment Sales Rep.: E-mail Address: Specifications Conveyor Length = Roller Centers = Between Frames Dimension = inches Powered Rollers = Every Roller Powered Every Other Roller Powered Roller Placement = 3" Centers 4.5" Centers 6" Centers Roller Surface = Steel Roller Without Lagging Steel Roller with NBR Lagging Powered Roller Electrical = 1/60/115 Volt 3/60/230 Volt Mean Elevation = (Top of Rollers) BMS Support HS Support

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