Flat Bellows Form row 1row 1 col 1 startCustomer DetailsDate:* DD slash MM slash YYYY Name:*Company:*Contact:*Email:*Industry:Phone Number:Address:*Environmental conditions/ProtectionExposureHot Chips Light Medium Heavy Cutting Oils/Coolants/Lubricants Light Medium Heavy Specify Type:*Particles Light Medium Heavy (specify type, e.g. Aluminum, glass, wood, stainless)Weld Splatter/Sparks Light Medium Heavy Water/Moisture Light Medium Heavy Grinding and Swarf Light Medium Heavy Salt or Sea Spray Light Medium Heavy Electrostatic requirements (specify)Clean Room Dry Safety or Dust Cover Food Grade/FDA Chemicals (specify type)Select anyone Light Mist Heavy Mist Light Spray Heavy Spray Flooded Submerged Temperature F C Ambient:Minimum:Maximum: UV/ Ozone Exposure Laser row 1 col 1 endrow 1 col 2 startType of Machine:*Model:*Manufacturer:*Axis:*Acceleration (m/sec 2 ):*Max Speed (m/min):*Movements per day:*Orientation: Horizontal Vertical Cross rail Application InformationMaterial:* Existing Cover New Design Please supply a sketch/drawing/CAD File (.dwg, .dxf, .stp) or photosQuantity Pc:*Right:*Left:*row inside col startDimensions (Please provide drawing (.dwg, .dxf, .stp). All dimensions in mmcol inside col 1 startcol inside col 1 endcol 2 inside col startA (Min)*B (Max)*C (Stroke)*D (Pitch)*E*col 2 inside col endMounting OptionsEnd 1: Mounting Plate Hook and Loop Fasteners Other (provide specs and drawing) End 2: Mounting Plate Hook and Loop Fasteners Other (provide specs and drawing) If holes are required, please supply drawing indicating location and diameterCAPTCHArow 1 col 2 endNameThis field is for validation purposes and should be left unchanged.