request form

Customer: ^*

Contact e-mail: ^*

Contact phone:

Project:

Customer order no:

Date:

Delivery time:

Machine manufacturer: ^*

Load capacity: ^*

Cab weight: ^*

Rope: ^*

Speed: ^*

Stroke: ^*

Traction wheel diameter:

Number and diameter of ropes:

Location:

Geared or gearless:

Left or right:

With or without encoder:

Deflection pulleys:

Diameter of the deflection pulley:

Note:

I agree with processing of personal data

^* mandatory items