Company Name

Company Phone Number

Direct Dial and or Extension

Contact Name

Email Address

Fax Number

Size of Platform

Weight of Items on Platform

(Include operating weights)

Height on Top of
Platform (standard 12")

Describe existing or new roof system (include insulation and any wind /snow load and any applicable city or state codes ie., wind seismic and zone.)

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mailing list as well?

  Yes
  No