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| 1) COMPANY NAME |
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| 2) TEL/FAX |
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| 3) ATTN/KEY-MAN |
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| 4) AREA |
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| 5) CONTACT METHOD |
TEL/VISIT |
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| 1) MATERIAL NAME & MODEL NO |
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| 2) MATER MANUFACTURER & SUPPLIER |
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| 3) ONE LIQUID TYPE |
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| VISCOSITY |
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| GRAVITY |
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| CURE TIME/CONDITION |
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| OTHERS |
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4) TWO LIQUID TYPE |
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A |
B |
| RATIO |
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| VISCOSITY |
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| POT LIFE |
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| CURE/CONDITION |
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| OTHERS |
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| 1) SHOT VOLUME (MIN/MAX) |
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| 2) SHOT ACCURACY |
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| 3) SHOT TIMES(CAPACITY) |
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| 4) MAIN PRODUCTS/APPLIED PRODUCTS |
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| 5) EXPECTER Q'TY PER DAY OR MONTH |
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| 6) CASE COLOR/VOLTAGE/SIZE OF AIR
HOSE |
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| 7) REOMMEND DISPENSING EQUIPMENT |
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1) DISPENSING EQUIPMENT LIST
(BRAND /MODEL NO / Q'TY P/O TIME) |
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| 2) OTHER EQUIPMENT LIST |
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| 3) COMPETITOR INFORMATION |
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