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Products
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Contact Us
- Contact Us
- Application Forms

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Pick-Module Safety System
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Factory Supply Inc.

3412 49th Street North
Saint Petersburg, Florida 33710

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Request a Quote

QUOTATION TYPE*
CUSTOMER INFORMATION
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name*
First Last
Email*
Phone*
Cell*
PROJECT INFORMATION
Please Indicate What Unit of Measures You Intend on Using Within This Form*
- lb
- kg
- in
- cm
What are we picking up?*
What is the lifting surface like, i.e. smooth, rough, porous, etc.?*
Length
Length Minimum*
Length Maximum*
Width
Width Minimum*
Width Maximum*
Height
Height Minimum*
Height Maximum*
Weight
Weight Minimum*
Weight Maximum*
Type of Lift Required*
Operational Method*
Notes*
Maximum Swing Arm Length Requested*

Name*
First Name Last Name
Email*
Phone*
Company*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How many pits do you need covered?*
Internal WIDTH at top of pit*
Feet and Inches
Internal LENGTH at top of pit*
Feet and Inches
Is there a catwalk across the pit?*
Are there stairs into the bay?*
Is there steel edge along the total length of both sides?*
Do you need connection hardware?*
Do you have an oil drain pan?*
Upload A File
Drop files here or
Anything else we need to know?

QUOTATION TYPE*
CUSTOMER INFORMATION
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name*
First Last
Email*
Phone*
Cell*
Cart Specifications
Please Indicate What Unit of Measures You Intend on Using Within This Form*
- lb
- kg
- in
- cm
- N
Max Load Weight*
Is the Load to be Moved On*
What is the Wheel Configuration?*
Please Upload an Image of the Connection Point
Drop files here or
Will the Machine Need to Travel Up or Down any Slopes with a Load?*
Where will the Machine be Used?*
Do You Require a Stainless Steel Machine?*
Will the Machine be Operating in an Explosive or Potentially Explosive Environment?*
What Do You Want to Improve?*
Environment
Are Any of the Following Applicable for Your Environment?*
- Temperature
- Explosive
- Radiation
- Ingress Protection
- Clean Room
- Stainless Steel
- Other
Will the Machine Need to Travel Up or Down any Slopes With a Load?*
Please Provide the Degree Angle or Dimensions of the Slope*
Will the Machine Need to Travel Up or Down any Slopes Without a Load?*
Please Provide the Degree Angle or Dimensions of the Slope*
Will the Floor Be*
- Clean
- Wet
- Dusty
- Greasy/Oily
- Other
Will the Machine Need to Move Over Obstacles?*
Which Obstacles?*
- Curbs
- Speed Bumps
- Raised Rails
- Recessed Rail/Gaps in Floor
- Other
Please Note the Size of the Obstacles*
Please state the name of the obstacle, height/depth and width in inches.
Where Will the Machine Be Used?*
- Inside
- Outside
Usage
How is the Load to be Moved?*
- Push
- Pull
- Steer
What is the Approximate Distance Travelled Per Move With the Load?*
What is the Approximate Distance Travelled Per Move Without the Load?*
How Many Days in a Week will the Machine be Used?*
How Many Shifts are there Per 24 Hours?*
How Many Times Per Shift will the Machine be Used?*
How Many Times Per Hour will the Machine be Used?*
When can the Machine be Charged?*
How Long can the Battery be Charged During These Periods?*
Trolley Overview
Does the Trolley Exist?*
Is the Trolley Designed?*
Do you Require Advice on a Trolley Design?*
How Many Trolleys Do You Have?*
How Many Different Trolley Types Require Moving?*
If you have multiple trolley types we will require details for each type.
How Many Trolleys Require Moving at Once?*
Can we Attach a Standard Female Coupling?*
Trolley Details
Dimensions of the Load*
L x W x H
Height of Load*
Distance Between Casters Rotated In*
Is There an Overhang, If So What Size Is It?*
L x H
Are There any Obstructions on the Underside of the Trolley?*
If Yes, Please Provide the Dimensions of the Obstruction*
L x W x H
Wheel Material*
Wheel Condition*
Wheel Condition Notes*
Notes on Load*
What Are You Connecting To?*
- Square
- Rectangle
- Angle
- I-Beam
- U-Channel
- Round
- Half-Round
- Other (Please Attach Photo)
File
Drop files here or
If Connecting to the Square or Rectangle Please Provide Dimensions*
L x W x H
Is There Unrestricted Access to the Connection Point?*
Load Testing: Stain Read 1*
Load Testing: Stain Read 2*
Load Testing: Stain Read 3*
Load Testing: Stain Read 4*
Load Testing: Stain Read 5*
Additional Information
Comments
File
Drop files here or