Company:		Date:
Name:		Phone:
Address		Fax:
City:		E-mail:
Country/State:	Select Region Asia Africa Australia Europe Middle East North America Central America South America ---- ----	Customer RFQ # or Site:
Zip:		Installation Date:
		Quote Required by:

Form of Quote:	Please Select An Option Budgetary
Type of Tower:	Please Select An Option AM Tower Catenary Chimney Guyed Round Stack Self Supported Twin Towers Wind Turbine
Height of Tower:
Bridge Distance:	Please Select An Option 25 50 75 100 125 150 200 300
Appurtenance Height:	(Specify height, or zero)
Face Width:	(If unknown put 10 ft.)
Light Standards:	Please Select An Option FAA ICAO Transport Canada Non Standard
Lighting Color:	Please Select An Option FAA Type A - Low/Medium Intensity Red FAA Type D - Medium Intensity White FAA Type E - Medium Intensity Dual FAA Type B or C - High Intensity FAA Type F - High Intensity Dual
Red Type	Please Select An Option Incandescent LED Strobe
Wiring Type	Please Select An Option Wire/Conduit Included Wire Included - Conduit Not Wire & Conduit Not Included Cable Included Cable Not Included
Input Voltage:	Please Select An Option 120 VAC, 60 Hz 120/240 VAC, 60 Hz 220 VAC, 50 Hz 480 VAC, 60 Hz 12 VDC 24 VDC 48 VDC Not Listed
Phase:	Please Select An Option Single Three
Special Options: (required)	None 3SL/level 4SL/level LBRs Double Obs Cabled SLs OB w/Transfer Relay Joslyn Hanger Expansion Joints Remote Monitoring (RDU) SiteGuard DC-60
	None 3SL/level 4SL/level LBRs Double Obs Cabled SLs OB w/Transfer Relay Joslyn Hange Expansion Joints Remote Monitoring (RDU) SiteGuard DC-60
	None BCN Side Mount SL Mounting Bracket BCN Ice Shield High Intensity Side Mount High Intensity Swing Mount
	None BCN Side Mount SL Mounting Bracket BCN Ice Shield High Intensity Side Mount High Intensity Swing Mount

If you need additional parts quoted please enter the required data in the Questions/Comments section.

Questions/Comments: