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COMPANY INFORMATION    
* Company Name:  * Contact Name:
* Address: * Job Title:
* City, St, Zip: * Phone:
* # Presses: * Fax:
* # Employees: * Email:

PRESS INFORMATION    
Press Mfg & Model:    
#Units and Size: Ink Type: UV: Conventional: Other:
Roller Name/Mfg: Current Price: #Used a year:
Blanket Name/Mfg: Current Price: #Used a year:
Fountain Sol Mfg: Current Price: #Used a year:
Blanket Wash Mfg: Current Price: #Used a year:

BLANKET INFORMATION
Blanket Size:   X  Measured as:  Tip to Tip:  Blanket Only:
# of Plys:          Face Color: End Treatment: Punched: Barred:S/C:
Lead Bar Type:  Web: Extruded:    Lead Bar #:    Size:
Tail Bar Type:    Web: Extruded:   Tail Bar #:    Size:
Special Instructions:

ROLLER INFORMATION

Do specs match original Mfg. Specs?   Yes: No
                                                                           (If no, please provide specifications on second sheet)

What type of ink is used?                      UV: Conventional: Other:
Press Ready Rollers?                              Yes: No: Cover Only: Core and Cover:
Special Instructions:

FOUNTAIN SOLUTION & BLANKET WASH INFORMATION
Fountain  Solution:       Type:   Neutral: Mild Acid: Full Acid: Alkaline:  
                                         Water Source:   Rev Osmosis: Distilled: Tap Water:
                                         Water Conductivity: pHlevel:
                                        Additives:   Alcohol Sub: Alcohol: None:
Blanket Wash:              Miscible: Yes: No: VOC Level:
Special Instructions:

     
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