To Request A Quote For An Automatic Box Labeling System
Please Fill Out Form Accurately

A red * denotes a required field!

Follow Us On:	Copyright ©2011 Vande Berg Scales

CONFIDENTIALITY NOTICE: Any information contained in email correspondence, submitted through quotes, and/or any files transmitted with it through www.vbssys.com may be privileged or confidential and intended solely for the use of the designated recipient(s) of VBS, Inc. and will not be distributed to any third parties, external persons, or companies.

	First Name *

	Last Name *

	Phone *

	Email (we will keep your email completely private) *

	WebSite *

	Wash down
	Yes No
	Direct food contact
	Yes No
	Multiple Products Simultaneously
	Yes No
	Product Information:
	Length
	Minimum

	Maximum

	Width
	Minimum

	Maximum

	Height
	Minimum

	Maximum

	Weight
	Minimum

	Maximum

	Pieces per minute
	Minumim

	Maximum

	Division size
	Minimum

	Maximum

	Print/Apply
	yes No
	Apply only
	yes No
	Label Size and Location:

	In-Feed Conveyor Information
	Feeding Conveyor Speed

	Top-of-Belt Height

	Belt Width

	Max In-Feed Conveyor Length

	Scale Conveyor Information
	Top-of-Belt Height

	Belt Width

	Max In-Feed Conveyor Length

	Out-Feed Conveyor Information
	Top-of-Belt Height

	Belt Width

	Max In-Feed Conveyor Length

	Diverts
	Yes No
	Type of Diverts

	Do you have pictures
	Yes No
	Do you have drawings
	Yes No
	Additional comments