Engineered Systems Detailed Proposal Worksheet

This Worksheet covers the specific information required to design a New Monitoring Application or to make modifications to an Existing Monitoring Application. Please select the type (New or Existing) below for which you area requesting a proposal. Please complete a separate form for each location you want to monitor.

Please fill out the following form, including your personal information, to help us better serve you.

*Company:

*Name:

Title:

Address:

City/State/Zip:

*Phone:

  Fax:

*E-mail:


*Required

 

Monitoring Application

Other:

Briefly outline the specific components, use and requirements as you know them:
Location Information
Location Name:
Detector Info:
 No. of Existing: No. of New: (if known)
Detector Model(s):
Use comma to separate multiple models.

Controller Conditions

  Detector Conditions
Physical Location:
Indoor Outdoor
Wall Mount Rack Mount
Panel Mount  
Controller Temperature (indicate F° or C°):
Minimum: Maximum
Controller Humidity: RH
Condensing Non-Condensing
Available Electrical at Controller:
Volts AC: Volts DC:
Controller Hazard Rating:
Hazardous Non Hazardous
Restricted Access  

Explosion Rating:
  Division 1 Division 2
  Class I Class II
  Group A Group B
  Group C Group D
 
Local Conditions At Controller:
Dust/Mists Corrosives
Vibration Splash/Washdown

Interferences:
Radio (RFI) EMI
Controller Special Requirements:
Operate other equipment?
If Yes, What?

(ie. Fans, Alarms, Service or Proccess)

Replace Existing Equipment?
If Yes, where there problems we should try to work around?

Type of Alarm at Controller:
Visual Audible
Alarm Delay  
Relays Req.
Warn Fault
Mid High

Physical Location:
Indoor Outdoor
Wall Mount Duct Mount
Mount Equipment
Detector Temperature (indicate F° or C°):
Minimum: Maximum
Detector Humidity: RH
Condensing Non-Condensing
Available Electrical at Detector:
Volts AC: Volts DC:
Detector Hazard Rating:
Hazardous Non Hazardous
Restricted Access  

Explosion Rating:
Division 1 Division 2
Class I Class II
Group A Group B
Group C Group D
 
Local Conditions at Detector:
Dust/Mists Corrosives
Vibration Splash/Washdown

Interferences:
Radio (RFI) EMI
Detector Special Requirements:
Operate other equipment?
If Yes, What?

(ie. Fans, Alarms, Service or Proccess)

Replace Existing Equipment?
If Yes, where there problems we should try to work around?

Type of Alarm at Detector:
Visual Audible
Alarm Delay  
Relays Req.
Warn Fault
Mid High
Options & Accessories:
Back-up Power Repeater Display Installation  
Data Logging Spare Parts Calibration Kit  
Training Startup Service Service Contract  

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