INSTRUCTIONS: Complete This Form. Date: 5/24/06

Mail or Fax To: Savant Automation Inc.

2748-A Courier Dr NW

Walker, Michigan 49543-1267

Phone: (616) 791-8540 Fax: (616) 791-8598

Attn. Sales Dept: Garry Koff 616 791-8540 X221 or Scott Sutton X233

Email to: or

PROJECT INFORMATION:

CORPORATE CONTACT SITE INSTALLATION

Customer Name:

Address:

Contact Name:

Email Address:

Title:

Telephone No.:

Fax No.:

Expected Purchase Date:

Desired Delivery Date:

If the Project is to be completed in phases, describe:

Facility: New Existing

Pricing Required: Budgetary Firm Price

Project Funding: Approved Budget Pre-Approval Feasibility Phase

Installation Labor: Union Non-Union

Is Simulation Required? Yes No


PROJECT ISSUES:

What Issue(s) are Driving the Project?

What Product Features are Most Important?

What are the Customer’s Goals?

Why AGV over other technologies?

LOAD INFORMATION:

Product to Be Moved:

Product Handled On/In: Pallet Rack Tote Slip Sheet

Other - Describe

Load Weight: Per

Overall Load Dimensions: “ Long “ Wide “ High

VEHICLE TYPES OFFERED:

/ TUGGER
Proceed to page 3 / / COUNTER-BALANCED FORK
Proceed to page 4
/ UNIT LOAD CARRIER WITH ROLLER DECK
Proceed to page 3 / / AUTOMATIC TRUCKING LOADING FORK
Proceed to page 4
/ UNIT LOAD CARRIER WITH LIFT/LOWER DECK
Proceed to page 3 / / MATERIAL TRANSPORT GUIDED CART
Proceed to page 5
/ STRADDLE
FORK
Proceed to page 4 / / ASSEMBLY LINE GUIDED CART
Proceed to page 5
TOW VEHICLE
10,000 lbs. capacity
30,000 lbs. capacity
50,000 lbs. capacity / / Number of Trailers to be Towed:
Number of Loads Per Trailer:
Number of Load Positions Per Trailer:
Total Towed Weight Including Trailers:
New Trailers? / Existing Trailers? / Weight lbs. (empty)
Trailer Size: / “Long / “ Wide / “ High
Trailer Capacity: lbs. / Coupler Type: / Coupler Length: “
Trailer Steering: / Caster / 4 Wheel (linked) / Fifth Wheel
Load Overhang on Trailer: / “ Long / “ Wide / 8 “ High
Any Special Loading or Unloading Other Than by Forklift, Explain:
UNIT LOAD CARRIER
WITH POWERED ROLLER DECK
6,000 lbs. capacity
8,000 lbs. capacity
10,000 lbs. capacity / UNIT LOAD CARRIER
WITH LIFT/LOWER DECK
2,500 lbs. capacity
6,000 lbs. capacity
8,000 lbs. capacity
Single load position: Dual load position: Other:

Dimension of load perpendicular to vehicle fork direction: “
Type of Pick or Drop Station (choose one or more):
Load Rail Stand Powered Conveyor Drive Thru Parasitic Drive
Load Transfer Interface Height All Locations have same “ above floor transfer height
Locations have different transfer heights above floor, as follows:
1st “ 2nd “ 3rd “ 4th “
FORK VEHICLE
STRADDLE LEG STYLE
2,000 lbs. capacity
4,000 lbs. capacity
6,000 lbs. capacity / FORK VEHICLE COUNTER BALANCED
1,200 lbs. capacity
5,000 lbs. capacity / ATL VEHICLE
AUTOMATIC TRUCK LOADING
3,000 lbs. capacity
5,000 lbs. capacity

Dimension of load perpendicular to vehicle fork direction: “
Type of Pick or Drop Station (choose one or more):
Load Rail Stand Conveyor Stand Floor – Single Position Floor - Positions Deep
Load Transfer Interface Height All Locations have same “ above floor transfer height
Locations have different transfer heights above floor, as follows:
1st “ 2nd “ 3rd “ 4th “
AUTOMATIC GUIDED CART
FOR MATERIAL TRANPORT USE
800 lbs. capacity
1,700 lbs. capacity
3,600 lbs. capacity / AUTOMATIC GUIDED CART
FOR ASSEMBLY LINE USE
800 lbs. capacity
1,700 lbs. capacity
3,600 lbs. capacity
Type of Pick or Drop Station (choose one or more):
Operator load/unload Powered Conveyor
Non-powered conveyor
Load Transfer Interface Height is “ above floor / Type of Assembly stations (choose one or more):
# of manual process stations
# of automatic process stations
Work piece rotation required? Yes No
Work piece elevation required? Yes No


SYSTEM LAYOUT:

All Indoor Indoor / Outdoor

Length of Path: Feet (Including Bi-Directional Footage)

Number of Stops:

Narrowest Aisle Width: Inches

Floor Surface: Concrete Wood Block Steel Tile/Plate

Poly Block Wood Plank

Floor Condition: Rough Smooth Minor Cracks Wet

Dry Oily Metal Chips

Are Floor Repairs Needed?

Floor Discontinuities:

Expansion Joints, Size , Number

Drains or Sewer Covers, Size , Number

Railroad Tracks, Number

Bridge Crossings, Size , Number

Fire Doors, Number Automatic Doors, Number

Ramps, Number “ Long “ Wide “ Rise

LOAD ACTIVITY:

From / To / No. of Loads/Hr.
. / From / To / No. of Loads/Hr.
Peak / Avg. / Peak / Avg.

Number of Shifts Per Day: Number of Hours Per Shift:

Basis for Activity Rates: Current Rates Forecasted for Year

(Other - Please Indicate)


BATTERY CHARGING SYSTEM:

Standard Manual Exchange

Opportunity Charging

SYSTEM MANAGEMENT:

Vehicles will be Dispatched Via:

Onboard Vehicle Selection Panel

Local Control to Call Vehicle……How many AGV calling locations?

Load Sensing on P/D Stand to Call Vehicle…… How many AGV calling locations?

Control Interface to Other Equipment / Computers?

No Yes – Describe

Real Time System Monitor Display Required Not Required Desired

DESCRIBE SYSTEM OPERATION:

SYSTEM SAFETY:

Are there any specific safety issues? If so, explain:

SYSTEM LAYOUT:

Please Do One of the Following:

Submit AutoCAD Drawing of Customer Facility with Suggested Path Route

Use Q-CANDesigner Trial PC Program to Create System Model with Suggested Path Route

Provide Sketch Of AGV Path

Mail, Fax or Email to Address Indicated on Page 1

If AutoCAD or pdf files are unavailable, please provide hand sketch of facility layout with suggested path route and station locations.

Include all fixed equipment, columns, etc. that are not movable. Also provide as much dimensional detail as possible such as aisle widths, distance between columns and fixed equipment, etc. that may affect the path route.


Note: Include material flow and proposed operational descriptions.

Savant Automation, Inc page 9

2748 A Courier Dr, NW

Grand Rapids, MI 49534