Custom Unit Quotation Request

Please fill out this form completely so we may promptly process your request.

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Is this a modified AGI Part?

Yes

No

If yes, please complete this section of the form:

AGI Part Number: Description of modification: Required quantities: 1-5 5-10 10-20 30-50 50-100 100-200 200

If no, please complete this section of the form:

Type of product: Gripper Slide Rotary Actuator Escapement Tool Changer Motion Module Is this to replace a competitor's product? Yes No If yes, please fill out this information: What is the problem with the unit? What is the application? What is the part number? Required Quantities 1-5 5-10 10-20 To send us a drawing, please address e-mail to info@agi-automation.com, and add file as attachment. If no, please fill out this information: What is the working PSI? Describe Payload, Number of Cycles, and Temperature: Special Requirements: Required Quantities: To send us a drawing, please address e-mail to info@agi-automation.com, and add file as attachment.