Dealers Of

Proud Member of

Chsa
nfcoc

Certified by

Cwb
Canadian Welding Bureau

HOISTS QUOTATION REQUEST FORM

The information that you provide us on yourself and your company will be used exclusively by Provincial Services only. Once you have completed the form click the "Send" button located at the bottom of the page, the information will be sent via e-mail to our main office in Allanburg, Ontario. No information will be passed on to outside parties. Should you have any questions or concerns please feel free to contact our office at 1-800-350-7250(Canada Only) or 1-905-384-0411.

Allow 2-4 days for quotation. Should you require any assistance please call one of our sales representatives at 1-800-350-7250(Canada Only) or email sales@provincialservices.com.

Your Name
Your Company Name
Your Company Address

Business Phone No.
Business Fax No.
E-Mail Address
How did you learn about our company

Have you dealt with us before:
Yes
No

HOIST INFORMATION


1. Base Quotation On:
Supply Only
Supply and Installation

2. Number Of Hoists Required:

3. What Is The Load Capacity You Are Required To Lift

4. Operating Environment:

5. What Type Of Hoist Would You Like Quoted:
Lever Hoist
Manual Hoist
Electric Chain Hoist
Wire Rope Hoist
Air Hoist

6. What Voltage Supply Do You Require:
110 Volt
230 Volt
460 Volt
575 Volt
Other

7. What Type Of Suspension Do You Require:
Hook
Lug

8. What Type Of Trolley Do You Require:
Plain
Geared
Motorized - Single Speed
Motorized - Dual Speed

9. What Type And Size Of Beam Is The
Trolley And Hoist To Operate On?:

10. Briefly Describe The Application The Hoist Is Used For:


11. Do You Require Any Accessories
(eg. Chain Container):


12. Do You Require A Certain Manufacturer:

If all the information above is correct click the "send" button.

Allow 2 - 4 days for quotation. Should you require any assistance please call one or our sales representatives at 1-800-350-7250 or e-mail sales@provincialservices.com