Vacuum-Automation-Systems (VA-SY)
Questionnaire to create an offer

Remark:Dear customer, this form helps to quote faster and have a technical correct project management.

Please note all available data.

For a budget price, please fill in the fields marked in yellow.

1.Contact information

Company:
Company:
Department:
Street, No.::
Zip-code:
City, country: / Contact person:
Phone:
Fax:
E-mail:
Type of request:
Other: / visite-mail phone
Date:

2.Description of the handling process

3.Workpiece

Workpiece description:
Dimensions:
/ L
[mm] / B
[mm] / H
[mm] / d
[mm] / D
[mm] / Dmax
[mm] / Weight
[kg]
Single part / Min.
Max.
Layer / Min.
Max.
Material: / material: density: [kg/m³]
Surface: / flat & smooth rough structured
Fouling: / nonedrywetoilydusty
Suction density: / non porous porous
Filling: / noneyes
Type of gripping surface: / cover hollowsolid
Rigidity:
Distortion:
Part assignment: / yes no Δh= mm L = mm
yes no Δh max. = mm
no yes:
Are the plies homogeneous? / yes no:
Are other parts needed to be handled in addition to the workpiece?
yes no
material: size: description: weight:
How large is the maximum height difference?
Workpieces next to each other: Δh max.: mmcomplete layer: Δh max.: mm

4.Surrounding area specifications

Temperature: / workpiece: standard (+5°C to +40°C) °C (min./max.)
environment: standard (+5°C to +40°C) °C (min./max.)
Working area: / indoorsoutdoors

5.Transport, Gripping

Handling: / palletizingdepalletizingdisplaceothers

On which side is the workpiece gripped? /
anyhowon topbottomside
Turning: / noyes: °
Suction pad material “silicone” allowed (no surfaces that have to be coated)? / yes no
How large (max. overall size) may the gripping system be?
L: mmB: mmH: m

6.Description of the working cycle

Duration total cycle time: / t = sShift operation:1 2 3
Number of cycles / min: / n = 1/min
What are the maximum speed & acceleration values? / a = m/s²
v = m/s²

7.Interface specifications:

7.1Mechanically

Automation component:
Gantry robot Industrial robottype:
Which live load can be handled? kg
Specification of gripper weight: notspecifiedmax.kg

7.2Vacuum generator

The choice of a vacuum generator depends on the evaluation of the system.
Preselectionfor orientation:
Electrically
Pneumatic(ejector)
already installed: / type:

8.Quotation

Desired date for quotation:
Number of needed grippers:
Planned Budget:

Remark:Please send back the questionnaire via e-mail or fax. Thank you very much!

J. Schmalz GmbH

Johannes-Schmalz-Str. 1

72293 Glatten

Tel.: +49 7443 2403-406

Fax: +49 7443 2403-299

FO-PM-WW-027, Index 3, March 2017, HHR

Delivery Note for

Test samples

J. Schmalz GmbH

Attn:

Arrival C9

Johannes Schmalz Straße 1

72293 Glatten

GermanyDate:

Dear customer,

please fill in the marked fields and enclose this form to the delivery.

Please fill in

Company:
Street:
Address line 2:
Postal code: / Country:
Contact person:
Phone:
E-mail:

Reference

Project title:

Offer number (if existing):

Test samples

Short description of the test samples:

Activities after the tests

Resend the test samples to

J.Schmalz GmbH is allowed to dispose the samples after testing.

Signature:

FO-SER-WW-015

Index 0

March 2017, HHR