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----------Section 1.0---------- Contact Details
Your Enquiry No.
*
Date
Company Name
*
Company Address
Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
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Dominican Republic
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France
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Gambia
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Guyana
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Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
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North Korea
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Latvia
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Liberia
Libya
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Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Northern Mariana Islands
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
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Samoa
San Marino
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Senegal
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Slovenia
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Somalia
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Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
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Taiwan
Tajikistan
Tanzania
Thailand
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Tonga
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Tunisia
Turkey
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Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Email
*
Phone
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Respone Req 'd by
Submitted by
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----------Section 2.0----------Existing Coupling Details
Existing Coupling (If Any): Make / Model / Size
Design
Elastomer
Disc
Gear
Tyre
Grid
Others
Details :
Outside Diameter
Overall Length
Length thru bore
Hub Dia
Distance Between Shaft Ends : (Prime Mover to Equipment or Gear Box Input)
Distance Between Shaft Ends : ( Gear Box Output to Equipment)
----------Section 3.0---------- Prime Mover Details
Prime Mover Type:
Electric Motor
Hydraulic
Engine
Turbine
Diesel
Gas
Steam
Air
Rating (Kw/Hp) Example : 10Hp Or 10Kw
*
RPM
*
Torque (Kindly Mention the correct unit of measurement)
Drive Shaft Diameter
Exposed Drive Shaft Length (If Available)
TICK ANY ONE BOX FROM THE BELOW GIVEN OPTIONS
Standard Pilot Bore
Finish Bore As per H7 & Js9 Tolerance
Taper Shaft (please provide Drawing)
Taper Shaft (please provide Drawing) File
Spline Shaft (please provide Drawing)
Spline Shaft (please provide Drawing) File
Other (please provide Drawing)
Other (please provide Drawing) File
Additional Drive End Connection Details ( SAE Flange etc.) Or Prime Mover Details
----------Section 4.0----------Drive Equipment and Application details
Driven Equipment Name
Driven Equipment Data
*
Driven Equipment Shaft Diameter
Driven Equipment Exposed Shaft length (If Available)
TICK ANY ONE BOX FROM THE BELOW GIVEN OPTIONS
Standard Pilot Bore
Finish Bore As per H7 & Js9 Tolerance
Taper Shaft (please provide Drawing)
Taper Shaft (please provide Drawing) File
Spline Shaft (please provide Drawing)
Spline Shaft (please provide Drawing) File
Other (please provide Drawing)
Other (please provide Drawing) File
Mounting
*
Horizontal
Vertical
Application Data & Driven Equipment details
Load Characteristics:
Unidirectional
Reversing
Smooth
Light Shock
Heavy Shock
Little Vibration
Med. Vibration
Hvy. Vibration
Duty Cycle:
Continuous
Operational Hours per 24Hrs
Intermittent
Please Specify Frequency
----------Section 4.1---------- For Applications Involving Gear Box please fill the below Table
Gear Box
Gear Box Make
Gear Box Ratio (Required)
Input RPM of Gear Box (Required)
Input Shaft Dia (Required)
Exposed Length of Gear Box Input Shaft (If Available)
Output RPM of Gear Box (Required)
Output Shaft Dia (Required)
Exposed Length of Gear Box Output Shaft (If Available)
Distance Between Shaft Ends Prime Mover To Gear Box Input shaft
Distance Between Shaft Ends Gear Box output shaft to Equipment shaft
----------Section 5.0---------- Addational Details:
Number of stops & starts: /24 Hours
Environmental Concerns (Temperature, Moisture, Dust, Corrosive Materials)
Estimated Required Qty:
*
Estimated Lead Time:
Service Factor Required by you:
Additional Details / Remarks
Enter Code
