REQUEST A QUOTE or order one of LTW's Ergonomic Industrial Workstations or Machine Bases!

Please fill out and submit the form below and one of our friendly sales personnel will help make your order process an "uplifting" experience!

REQUEST A QUOTE: PLACE ORDER PO#:

Company Name:

Contact Name: Title:

E-mail: Phone: Ext:

Company Website:

Cellular Phone: Fax:

Address:

City: State: Zip Code:

PROJECT NAME:

END USER (COMPANY NAME):

Select Base Model from pull down menu

Qty:

Sizes: Width (W) Depth (D) Height (H)

Tube Size:

Load Weight Capacity Required:

Motor Stroke:

Floor Contact Options:

Fork Lift Tubes:

Fork Lift Tube Center-to-Center Dimension:

Color:

Custom RAL# or Other

Paint Type:

Table Top:

Custom Table Top:

Table Top Mounts:

Custom Top Mounts:

WORKSTATION OPTIONS: Select all that apply to your application.

Overhead Light Shelf-Stainless Steel Shelf-Steel painted

Electrical Outlet Strip Tool Trolley & Rail Tool Balancer

Parts Bin Hanging Bar Fan Electric Tilt Top Frame

Additional Instructions:

Requested Delivery Date: (Note: 2-3 week standard lead time. Will vary due to manufacturing workload at the time of order.)

How did you hear about LTW Products?

Distributor/Manufacturer's Reps Name:

Distributor Salesperson Name:

Other Catalog, Distributor, or Man. Rep's Name:

Suggest a Catalog, Distributor, or Manufacturer's Rep in your area that you currently use:

Thank you very much!

01/26/2012 [ Home ]