Please answer the following eight questions so that we can begin work on your recent order
as soon as possible, many times we cannot proceed with the order unless we have all eight of
these questions answered. So please respond to these questions as soon as you can!

And again we thank you for choosing Automation Feed Systems!

Customer Name:

Quote Number:

Customer PO #:

1) What is the bowl rotation as you look at it from the top of the bowl?
Clockwise Counter Clockwise

2) Reconfirm the part orientation as it leaves our feed system by describing
the orientation you want:

3) By what date can you get us 2000-3000 part samples so that we can tool the bowl?

4) By what date will we receive a parts print of the parts we are required to feed?

5)Which color would you like? glossy white or flat black

6) If you have purchased a photocell shut off, would you like NPN or PNP?

7) What is the target discharge height above the floor that we are supposed to hit?

8) Will you be providing a layout drawing to us of any kind that we need to wait for
before we begin the feed systems' construction? Yes No
If so, by what date?

IMPORTANT: This form will only work with Internet Explorer. If you are using Netscape Navigator, please print this form out and fax it to Automation Feed Systems at (949) 420-2697.