Please fill out as much information
                              as possible, and fax to (704) 365-3578

Company ______________________   Name _________________      Date  _____/_____/_____

City ________________ State ______  Phone # _________________ Fax # _________________

Position ______________________________  e-mail ____________________________________
 

Line  _____________________________________/ Process ______________________________

Product __________________ Size ___________  Shape ___________ Weight/Lin Ft _________
 
Belt Type ___________________________  Pitch  ________________ Chains _______________
Number _________________________________________________________________________
Description _______________________________________________________________________
Material  __________________________ Color ______________  Type Rods _________________

Width _________ Edge Fixation _______ Length  ___________  C-C_____  Total Length _______

Flights _______________________  Height __________ Centers ______________ Indent _______

Guard Edges __________________  Height _________  Type______________________________



Sprocket Diameter  _______  Teeth ____ Material  ______Color  _____ Qty _______ 
 Bore ______  Shape _______  Key ____  SS_______  Pt# ____________________

Sketch:






 

 



 


Thank you. Please feel free to contact us at any time (800) 634-1114

                                         
BS&k Company
2248 Lawton Bluff Road,      Charlotte,    NC    28226       (800)634-1114[Phone]        (704)365-3578[Fax]