Fallas Automation Quote Questionaire (Fill out or check all that apply) 7000 Imperial Dr. P.O. Box 20354 Waco, TX 76712 254-772-9524 ext 1   Cell: 254-722-5831 FAX: 254-751-1242 sales@fallasautomation.com Your Contact Information Company Name:   Contact Name: Company Address(to send quote to):   Phone:   Cell:   Fax: Phone:   E-mail: Fax:   Address for Equipment:         Project Information Status of Project:   Preliminary   Funded   Approved Purchase Date:     Delivery Date:   Electrical, Mechanical and Controls Specifications: Installation Date:   Fallas Standard: Contact sales@fallasautomation.com Start-Up Date:   If Yours, E-mail to sales@fallasautomation.com Production Date:     Product Information Product Description: If you have a packaging matrix, e-mail to sales@fallasautomation.com Solid  Liquid  Granular  Powder  Frozen  Loose   Type of Package Rate (Packages per minute) Length Width Height oz. lbs. Type of Case Pack Pattern Number (Click to View) 1. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 2. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 3. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 4. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 5. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 6. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 7. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 8. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 9. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 10. Please Select Poly Pillow Bag Gusseted Bag Zippered Bag Tray Carton Tub Bottle Can Other Please Select RSC HSC Tray Bliss 4-Corner Post Re-Usable Other Please Select Pattern 1 Pattern 2 Pattern 3 Pattern 4 Pattern 5 Pattern 6 Pattern 7 Pattern 8 Pattern 9 Pattern 10 Pattern 11 Pattern 12 Information About Your System Feeding the Case Packing System & Misc Horizontal or Vertical   Elevation:   Jaw Height: Product Output: Single or Double   Are your cases overfilled?: Yes No Orientation of product at your discharge: Width Leading or Length Leading Will any of your equipment be integrated into the case packing system: Labelers   Printers   Sheet Inserters   RFID   Plant Environment: Dry   Wet   Dusty   Soap & Water Washdown   Caustic Washdown   Temperature   Humid   Ceiling height where equipment is installed: Minimum length, width, height limitations for transporting equipment through your plant: Length:   Width:   Height: Plant Voltage (VAC):   Plant Air (PSI): Communication Preference: Serial   PC Ethernet   PLC Ethernet/IP   DeviceNET   ControlNET   Other   Comments or Special Instructions: