GCI Application Data Sheet (Print & Fill out)
505 County Road 40 NW
Garfield, MN 56332
800-758-5126, Fax 320-834-2212

Company Name:____________________ Contact Name:_______________________
Street Address:_____________________ Phone: (___)________________________
City, State, Zip:_____________________ Fax: (___)__________________________
Proposal Requested: ___Budgetary ___Firm, Need Proposal: (date) ___/___/___

Air Pressure & Size of Line at Install Area ________Size _________psi
Electrical _______110/220 _______230 3ph _______460 3ph

Products to be Handled:_________________Current Handling Method:__________________
Max Cycles/Hour:________________________ Shifts per Day:_________________________
Environment:__Wet __Corrosive__Dust__Abrasive __Explosive __Clean, Temp _______

       Weight (lbs)   Height   Width      Length      I.D.      O.D.
Max:__________   ______  ______   _______   ______  _______
Min: __________  ______   ______  _______  ______   _______

Maximum/Minimum Reach Needed:_____/_____Inches from Center Line of Arm
Distance to Bottom of Product at Lowest Position:_________Inches
Distance to Bottom of Product at Highest Position:_________Inches
Please Indicate Where Measurement Was Taken From:_______________________________
Floor, Platform, Etc.
Clearance Factors:

Distance to lowest fixed overhead obstruction which can't or would not be moved:
_____________inches from floor.
Obstruction:___________________________________________________________________
_____________________________________________________________________________

Mounting Preference:

____Fixed Floor Mount ____Fixed Overhead Mount
____Portable Forklift/Pallet Jack Base ____Mobile Overhead Bridge Mount

End Tooling Preference:____Hook ____Gripper ____Vacuum ___Expanding Probe
____90^o Tilt ____180^o Tilt ______________________________Other

Special Handling Considerations: Grip Area, Pressure, Temp, Other, Describe:
____________________________________________________________________________
____________________________________________________________________________

The following is vital to our understanding of your requirements, please supply
as completely as possible:
-Parts Drawings -Photos of area and parts to be handled
-Machine Layouts -Video of area and current process
-Layout Drawings -Sample Parts (may or may not be needed)

Comments and Sequence of Operation:___________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

   Side View/Ceiling Truss                                     Top View (Layout Sketch)

Return To:
GCI - 505 County Road 40 NW
Garfield, MN 56332
Fax 320-834-2212