Light/Medium Duty Roll-Up Covers Click here for a PDF version of this form "*" indicates required fields Step 1 of 4 25% Contact InfoName* First Last Company Name* Email* Phone Number* Rep Information AddressAddress Street Address Address Line 2 City State / Province ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Application InformationQuantity Required:* Roll-Up Cover Type* Roll-Up WITHOUT Canister (ignore Canister sections) Roll-Up WITH Canister (complete Canister sections) Shade Material Coated Fabric Metal Dynatect Recommendation Other New or Existing? Replacement/Existing Design New Design (attach on right) If New Design, Upload Here: Drop files here or Select files Accepted file types: pdf, jpg, jpeg, png, doc, docx, xls, xlsx, ppt, pptx, stp, step, dxf, dwg, slddrw, sldprt, idj, ipn, ipt, idw, ide, tif, tiff, Max. file size: 12 MB, Max. files: 5. Any Additional Notes:Environmental ConditionsChips Light Medium Heavy Are the chips hot? Yes, hot chips Cutting Oils/Coolants/Lubricants Light Medium Heavy Specify Type Provde MSDS composition pagesParticles Light Medium Heavy Specify Type Water/Moisture Light Medium Heavy Grinding and Swarf Light Medium Heavy Weld Splatter Light Medium Heavy Electrostatic Requirements Clean Room Dry Safety or Dust Cover FDA Specify Requirements: Chemicals: 0%-35% 35%-55% 55%-100% Specify Chemicals Temperature Range °F °C Ambient: Min. Max. Maximum Travel Speed Acceleration: Cycles/Day Axis: Dimensions Shade Width (A): Maximum Shade Extended Length (B): Maximum Height/Depth (C) Canister, or maximum rolled up diameter if no canisterOverall Width for Canister or Roller (D) Roller Mounting BracketsIf Roll-Up Cover without canister, bracket size is determined by maximum roll-up size Roller Mounting Brackets: Both bracket with round holes One bracket with round hole, one bracket with slot (standard) One bracket with round hole, one bracket with rectangular hole (option) Cover Orientation & Shade Exposure to Work AreaFor Direction of Shade Exposure to Contaminants: Refer to "Top" or "Front" or opposite to indicate side exposed to contaminant. This depends on the shade orientation to the work surface, and whether the shade is protecting or containing debris. Direction of Mounting / Cover Orientation Horizontal Vertical (up-down) Crossrail (left-right) Horizontal Cover Orientation Horizontal #1 (HZ1) Horizontal #2 (HZ2) Direction of Shade Exposure to Contaminants Contaminant from the Top Contaminant from the Bottom Shade Support Unsupported Supported If Supported, put the Distance between Support (D) Crossrail Crossrail #1 (CR1) Crossrail #2 (CR2) Direction of Shade Exposure to Contaminants Contaminant from the Top Contaminant from the Bottom Vertical Bottom Vertical Bottom #1 (VB1) Vertical Bottom #2 (VB2) Vertical Top Vertical Top #1 (VT1) Vertical Top #2 (VT2) Direction of Shade Exposure to Contaminants Contaminant from the Top Contaminant from the Bottom Shade MountingShade Mounting Bracket K1 K2 K3 K4 K5 K6 K7 K8 Canister MountingCanister Mounting Options Code E1T Code E2T Code E3T Code E4T Code E5T Code E6T Code E1B Code E2B Code E3B Code E4B Code E5B Code E6B Horizontal canister mounting examples shown below. Adjust canister mounting style based on orientation selected on previous page. Code E7 - Custom or Special Mounting Drop files here or Select files Accepted file types: jpg, png, pdf, dxf, dwg, Max. file size: 12 MB, Max. files: 5. Please supply a drawing (DXF or DWG) or photo of your application if the above examples do not applyMiscellaneousWiper or Scraper Option: Brush (Standard) PVC Felt Stainless Steel None Other Canister Surface Treatment: Raw Steel Painted Steel* Stainless Steel Other *standard paint is primer gray If other, clarify paint spec, etc.Additional CommentsCAPTCHAEmailThis field is for validation purposes and should be left unchanged. Be The First One to Know. Subscribe to Our Newsletter.