Date 1. For Mr./Ms. Company Name City & State 2. Use: To transport from 3. Quantity: 4. Type truck: Name Load capacity (net) Platform; Shelf; Box; to lbs. Floor Type: Caster-Steer; Fifth-Wheel; Trailer; Four-Wheel; Auto-Steer; Semi-Live; Dead; Skid; Dolly; Other Inside Outside 5. Dimensions (inches) wide x high above floor. high above deck. length x If possible, include a drawing or sketch via fax or e-mail 6. Constructed of: Frame: Deck: Superstructure: 7. End Racks / Push Handles / Stakes: Number Permanent. Removable. Style Location: 8. Shelves: How many? Ht. above deck: (include top and bottom) Clearance between shelves: up ( down. Edges turned 9. Running gear: How many swivel casters? Size: How many rigid casters / load wheels? Arrangement: Capacity per shelf: Size: Diamond Pattern. 4-Corner Pattern. If Diamond: dia. x face. dia. x face. tilt-type. non-tilt. lbs. ") Six-Wheel. Type wheels desired: (Consult pgs. 12 –13 of catalog.) Type bearings desired: (Consult pg. 11 of catalog.) 10. Other accessories? Wheel Brakes; Floor Truck Lock; Couplers; Swivel Lock; Wheel Bearing Seals; Other: Details: 11. Any critical clearances (for doorways, elevators, scales, etc.)? Specify 12. Special finish or color? Special markings? 13. Comments Still need help? Call, Fax or E-mail Your Name Co. Name Address City State Zip Hamilton Caster & Mfg. Co. 1637 Dixie Highway Hamilton, Ohio 45011-4087 Phone Phone: 800-733-7655 Fax Fax: 800-232-3733 EMAIL E-mail: info@hamiltoncaster.com 123