Bottle Pick RFQ Form

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General Information
Name*
First Last
Phone*
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Company*
Address
Street Address City State/Province ZIP/Postal Code
Bottle Trough Product

Dyna-Flo (Requires 3-3/4" tall beam, otherwise trough will hang below beam)

Product Details
Bottle Sizes Handled
Diameter: Height:
Beam Dimensions
Width: Depth:
A
B
C
D
Out to Out
E
F
Out to Out
Channel Profile in Either Orientation
Other Information/Comments to assist us in your request:
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CONFIDENTIALITY: The information submitted on this form will not be shared with any organization outside of Mallard Employees and does not put you on a mailing or E-mail List.