Opportunity Please enable JavaScript in your browser to complete this form.Submitted by:MartyRonTerriMikeLouisJoshSydLeoSherryWayneTravisCustomer Name/Location *Contact *PhoneEmailOpportunity Type *Opportunity TypeNew ProductRepair Pick Up RequestSight Unseen Repair RequestOnsite Service RequestMachine WorkDynamic BalancingOpportunity TypePick up when: *ImmediatelyTommorrowWhen in the areaCustomer drop off MonroeCustomer drop off KMUrgency *Need ASAP (Lightning authorized)Need evaluation ASAP (Overtime authorirzed)Quote Lightning Rush optionQuote Fast Pass optionQuote standard evaluation/repair timeLoad size/Truck needed: *I will pick it up50 LB. or less51 - 1500 LB1501-2500 LBMore than 2500 LBFlatbed with crane neededUpload nameplate or other file Click or drag files to this area to upload. You can upload up to 12 files. Skip to Submit if nameplate data is uploadedUrgency *Need ASAP (Customer Down)Tomorrow2-3 daysSoon - No added freight expedite costSpare only - No urgencyNew Product Needed *AC MotorDC MotorPumpGearboxTransformerDriveOtherNeed quote by: *ASAP, ready to buyOne weekTwo weeks - 30 daysEquipment Type *AC MotorDC MotorPump/Vacuum/BlowerMachine WorkEddy Current Brake/ClutchDynamic BalancingServo Motor RepairTransformerHydro GeneratorThermal StrippingMagnet RewindGearboxManufacturer *Lowest Cost New OptionABB/BaldorGELeesonMarathonSiemensTecoToshibaUS Motors/NidecWEGOther (Describe below)Horsepower/KWRPMFrame SizeEnclosureTEFCODPTENVTEAOWASH DOWNEXPLOSION PROOFAC Voltage230/46046057521304160120 SINGLE PHASE230 SINGLE PHASEArmature VoltageField VoltagePump Make *Pump/Blower Model NumberTransformer MakeTransformer Primary VoltageTransformer Secondary VoltageTransformer KVATransformer Type *Dry TypeOil FilledAuto TransformerInductorAnnealingOther (describe below)Gearbox/Gearmotor Make *Gearbox/Gearmotor Part NumberService urgency *Need ASAP (Customer Down)Tomorrow2-3 days1-2 weeksOther (Describe below)Service Type *Vibration AnalysisRAMS SystemLaser AlignmentCurrent Signature AnalysisMotion AmplificationInfrared ScanOnsite Fan BalancingEquipment Uninstall/InstallUltrasonic LubricationBearing ReplacementOil Sampling/AnalysisStorage ProgramsMaintenance ServicesUltrasonic Air Leak AuditMaintenance TrainingTransformer ServicePump Seal ReplacementOther (describe below)Describe machine work needed *Item to be balanced *CheckboxesDO NOT DROP SHIPNotesSubmit