CUSTOM ORDER FORM
Custom Sub-Assembly
Specifications
A
B
Enter the diameter of the link in inches
B
C
A
E
C
D
D
Enter the diameter of the link in inches
E
F
F
Working Load Requirement
Enter the working load in pounds
Quantity
Minimum order quantities will apply
Comments
Have you ever purchased this product from
us before?
Yes
No
If you answered “No” to the previous question,
what is your current source for this product?
Contact Details
Contact Name:
First
Last Company:
Address:
Address line 2
City:
Postal:
State / Province / Region
Zip Code Phone Number: Peerless Industrial Group 1416 E. Sanborn St., Winona MN 55987
Country
Fax Number:
Ph: 800-873-1916 Fx: 800-356-1149
• Email: custserv@peerless.com