RFQ Application Evaluation
ALL FORM FIELDS ARE REQUIRED!
1. TOLOMATIC CHANNEL PARTNER CONTACT INFORMATION
Tolomatic Channel Partner Company:
Salesperson Contact:		Salesperson Phone #:
2. CUSTOMER INFORMATION
Company Name:		Customer Name:
Email:
Customer Phone #:
Address:
City:		State/Province:
Country:		Zip/Postal Code:
Customer Type:	OEM  Integrator  End user / In house automation  Other:
Type of Equipment manufactured:		No. of Employees:
Customer Status:	Current Tolomatic Customer    New to Tolomatic Products
3. PROJECT INFORMATION
Project Reference Name:		Project Stage:	Concept  Quotation  Final Order
Description of product machine is producing or desired action:
Machine or Design Requirement:	New  Existing
If existing, explain why another solution is desired:
4. TARGET PRICE REQUIREMENTS
Budgetary Pricing Only    Firm Quote		Requested Target List Price:	$ each
5. COMPETITIVE EVALUATION
Are multiple suppliers being considered for this application?  Yes    No    Unknown If YES, indicate which other suppliers being considered and what products are being specified:
6. QUANTITY / DELIVERY REQUIREMENTS
Product Quote Quantity:
Prototype Required:	Yes   Qty:    No
Estimated usage:	Annually    Quarterly    Monthly    One Time
Target Lead time requirements:	Prototype / Initial Order       Estimated Production Time Line
7. DESCRIBE THE PROJECT/APPLICATION
Technology/Product Used:	Pneumatic    Electric    Power Transmission
Describe what the machine or application is doing and/or what it needs to do.
Describe what the Tolomatic product needs to do on the machine or in the application.
Provide a drawing, sketch, or picture of the application Link: Upload File:
Define the typical motion cycle.
How many cycles per minute?    Per hour?    How many hours per day?
What are the life requirements in: Cycles?    Years?    or distance in inches?
Tolomatic Sizing & Selection Software used?  Yes   Upload File: Link:  No   If NO, please fill out the appropriate Application Data Sheet found under the "Selection" section for the appropriate product being considered and upload it here.
Other Considerations Environmental:  No    Yes   If Yes, check all that apply and explain:    Temperature      Humidity      Exposed to the Outdoors      Metal, Dust, or Particulate Contamination      Exposure to Corrosives / Washdowns / Abrasives     Shock & Vibration from application or machine events
8. CUSTOMER SPECIAL REQUIREMENTS
Is there a standard product part number, or Tolomatic product that will require modification for your project?  Yes (List Part Number or Product Name)    No   If yes, what modifications are desired and what do you want to accomplish by implementing them? Do you see the solution being modifications to an existing Tolomatic product, or the project starting from scratch leading to a new design?  Modified Standard Product - Describe    Custom Product - Describe
9. Please provide any additional Comments to help us better understand your application requirements.
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