ORDER REQUEST FORM

Client’s  Name Surname  Company  Company Address  Phone/Faximile/GSM No    e-mail adrdress/WEB     Name of the Project  Address of the Project Building  Purpose of Usage Domicile External of Domicile Hospital Plant  Stage of the Building Project Stage Foundation Stage Rough Construction Stage Ready-Pit Stage  Floor Number   Stop Number    Total Movement Distance   Independent Unit Number   Lift (This part will filled according to Preliminary Project information if existing.)  Capacity (Kg/Persons) 320/4 400/5 630/8 800/10     100 1000 1250 1600 2000  Speed 0.40 m/sn 0.63 m/sn 0.63/0.15 m/sn 1.00/0.25 m/sn 1.20 m/sn 1.60m/sn 2.50m/sn Other  Drive Type Mono speed Dual speed Stepless VVF Hydraulic  Commander Type Normal Summation commander Duplex  Type of Floor Doors Semi-automatic Full automatic From the center Telescopic  Material of Floor Doors First grounded E.Static painted Rustproof Aluminium Other Material    Automatic Cabinet Door None Yes       [Building License is a must if after April 1996]  Cabinet Coatingı Laminate Fiberboard E.Static Aluminium Carpet Other    Special Request