SKID UNIT QUOTE REQUEST FORM

The following information must be completed in full in order to process your quote request correctly. Fill out all information, if it does not apply fill in N/A or give an explanation. Failure to include the proper information will only delay your request.

* = Required Field
CUSTOMER / COMPANY INFORMATION
* Department / Company Name:
* Street Address:
* Mailing Address:
* City:
* State: * Zip:
* Name:
* Title:
* Phone(1):
Phone(2): ex. 402-568-2200
* Email: ex. johnsmith@yahoo.com

MISCELLANEOUS INFORMATION
         (Information is to help ensure that the skid unit will fit the application as specified)
Chassis Make:   * Please Select One
Model: 8' Pick-Up Box
Year: 6' Pick-Up Box
GVWR: 5' Pick-Up Box
Front:
 Utility Body :   
Rear:
 Flatbed Body: 
PayLoad: Other:             

Brushwacker / Skid Unit
.
                                     If Custom Specify: Gallons   Lenght Width
.
.

 
                                    If Other Specify:

.
  Remote 3.5 Gallon Fuel Tank
.
.
.
  1" Refill or Recirculate Line with quarter-turn valve (Pump Discharge to Tank)
.
  2"Akron quarter-turn valve tank to pump
.
.
.
. One (1) 12-volt Work Light
. Tank Color - Natural Textured Black
.


         NOTE: Drawing shown is based on standard options as listed above.

Installation or Shipping
* Please Select One
   Customer to pick-up complete unit at factory Snyder, NE (NO Mounting or Installation)
   Installation and Mounting at Factory.
   Shipping/Crating FOB Destination:
Company Name:
Street Address:  
City:                     State: Zip:
 
Comment / Notes

 

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