NETEC Equipment Jered LLC 103 Shipyard Drive P. O. Box 904 Brunswick, Georgia 31521-0904 (912) 262-2050 tel (912) 262-2041 fax

Equipment Quote Request Form

You can browse through some samples of equipment we have already manufactured. If you are interested in a model that already exists, or a modification of a model that exists, please indicate that model:

Model X-		Modified?	YES NO
I would like to modify this by: Otherwise, please indicate your equipment needs by filling out the information below. If you are unsure of your requirements, please feel free to call us at (912) 262-2050. One of our sales representatives will be happy to speak with you.

Type of Vessel:
Barge	Tug	Offshore Vessel	Non-Marine
Government Details:			Other Details:

Type of Duty:	Type of Power:
Escort	Electric
Anchor Handling ANCHOR WEIGHT IN LBS	Hydraulic
Line Handling	Diesel
Towing	Air
Other

Line Pull Required: LBS	Line/Chain Speed Required: FT/MIN
Wire Rope/Chain Size: IN	Brake Holding Capacity: LBS
How Much Wire: FT	Other Details:
Comments: (Please describe your application.)

Name	Title
Company	E-Mail
Telephone	Fax
Date