Belting Installation Estimate
Field Questionnaire
1 Customer name, job site address, contact name, and phone number?
Customer / Company
Job Site Address
Contact Name
Phone Number
2 Billing customer's account #? *
3 Name or number of unit or conveyor / system?
4 Is this an MSHA site or other government regulated facility?
If so, which?
Will techs need other certifications?
a. Organization / Type of certification
b. On-site training time
5 Job scope — what will our techs be doing on site?
6 Will the belt be installed and ready for us to splice?
a. Will CapCorp be removing old belt and installing new?
7 Is the belt currently on the system?
8 Type of splice
9 Belt specifications
Manufacturer
Plies
PIW
Grade
Width
Length
10 Location details
Ground level or elevated?
Is the system over water?
Height (if elevated)
Are there cat walks?
Will customer provide lifts?
11 Indoor or outdoor?
12 Will customer provide power (110v & 480v 3-phase, 30 amp)?
13 System condition
Is the system free, clear, and in working order?
a. Take ups in working order, not frozen?
b. Pulleys and idlers in working order?
14 Type of take up?
a. If gravity, who raises/lowers counterweight?
15 Will guards, hoods, covers, idlers be removed and replaced by customer?
16 Pictures of the system
Please attach photos to your email after the form opens it:
a. First 8 ft from tail pulley & surrounding area
b. Counterweight area (if applicable)
c. Whole system / as much as possible
b. Counterweight area (if applicable)
c. Whole system / as much as possible
17 When would the customer prefer the job done?
Preferred Date
Start Time
Time Allotted
18 Do you need a quote on the belting?
a. If so, do you need the belt:
NOTE: After we review the above information, we will decide if we need to send someone to inspect the system.
Opens your email app with all answers pre-filled