PROJECT NAME
Room#:
Room Application
Date
User
Address
Email:
Phone:
Fax:
City
State
Zip:
Quote required by:
Format:	Budget:
Field Sales Rep:
Other Bidders

TYPE OF ROOM NEEDED: (Check all that apply)
	Cold Room
	Warm Room (incubator)
	Wide Range Room (4° C to 40° C)
	Wide Range Room (-20° C to 10° C)
	Wide Range Test Chamber (Cycling)
	Freezer (-20° C)
	Freezer (-30° C)
	Blood Bank Refrigerator
	Blood Bank Freezer
	Animal Growth
	Plant Growth
	Diurnal Temperature
	Ramping Temperature
	Diurnal Lighting (Stepped)
	Diurnal Lighting (Ramped)

Room Location (ambient conditions)
	Inside with air conditioning
	Inside without air conditioning
	Outside: City State:
	Other Conditions (explain):

PERFORMANCE SPECIFICATIONS:
Temperature:		From   to
Control capability		1. +/- 0.5° C
		2. +/- 0.2° C
		3. +/- 1.0° C
		4. Other +/- ° C

Humidity: (if required)
	1. From   to
	2. Add only
	3. Subtract only
	4. Both Add and Subtract
	5. Control +/- 5.0%
	6. Normal Operating Range
What utilities are available for additive Humidity?
	1. DI Water
	2. Domestic cold only
	3. Low pressure stream
	4. High pressure stream
	Moisture available from product? Explain.

Ventilation required: CFM
Changes per hour
Room Construction:
Length:		Width:		Height:
1. ID		2. OD

Room Finish:
Interior
	1. White stucco galvanised steel
	2. White stucco aluminum
	3. Smooth aluminum painted white
	4. Galvalume or galvanized steel
	5. Stainess steel
	6. Other
Exposed Exterior
	1. White stucco galvanised steel
	2. White stucco aluminum
	3. Smooth aluminum painted white
	4. Galvalume or galvanized steel
	5. Stainess steel
	6. Other
Unexposed Exterior
	1. Same
	2. Galvalume or galvanized steel
	3. Other
Floor
	1. 14 ga. galvanized steel
	2. 14 ga aluminum
	3. Gray rubber mats
	4. Stainless steel
	5. Floorless
	6. Other:
Ramp
1. None     2. Interior     3. Exterior
Door
	1. 34" X 78" (standard)
	2. 48" X 78"
	3. 24" X 78"
	4. Other:
Window in door
	1. 14" X 14"
	2. 14" X 23"
	3. Other:
Refrigeration:
	1. Indoor
	2. Outdoor
	3. Winter controls
	4. Extreme cold
	5. Air cooled
	6. Water cooled
	7. Horizontal distance from evaporator
	8. Vertical distance from evaporator
	9. Semi-hermetic compressor (standard)
	10. Hermetic compressor
	11. Scroll compressor (2hp and larger)
Air Handler:
	1. Standard low profile/low velocity
	2. Grid ceiling
	3. Plenum wall conditioning system
	4. Plenum wall return
	5. Low vibration ambient chamber
	6. Other:
	7. Clean room class
Defrost system (5°C or cooler)
1. Air     2. Electric     3. Hot Gas
Lighting:
	1. Fluoresecent
	2. Incandescent
	3. 25ft. candles (storage)
	4. 50 ft. candles (standard)
	5. 75 ft. candles (high level)
	6. Other:
Control and Alarm Panel:
	1. PLC Series (standard)
	2. Touch Screen
	3. Chart recorder
	A. 1-day circular Single Pen B. 7-day circular Two-pen C. 30-day circular
	4. Electric
	5. Mechanical
	6. Other:
Utilities:
	1. 208-3-60
	2. 208-1-60
	3. 230-1-60
	4. 115-60
	5. 480-3-60
	6. AIR             PSI
	7. Steam
	8. Low Pressure
	9. High Pressure
	10. Drain Available
Assembled and Factory Tested:
	Yes           No
Installation:
	1. Factory installed
	2. Factory supervised w/trades
	3. User installed
	4. Other:
Chamber Location:
	1. Ground floor
	2. Upper floor
	3. Basement
Site Conditions:
	1. Existing building
	2. Renovation
	3. New Construction
	4. Loading dock
	5. Freight elevator (size: )
	6. Construction hoist
	7. Crane available

Access:
	1. Narrowest door
	2. Lowest opening
	3. Other:
Laboratory Casework:
	1. Stainless steel work benches with undershelf, back-splash and stainless legs. Lineal feet:
	2. Sink hardware.       Size:
	3. Standard counter (painted metal, resin tops, drawers and cabinets - supply sketch)
	4. Other:
Shelving:
	1. Perforated stainless
	2. Standard (open wire)
	3. Free Standing
	4. Wall (cantilevered)
	5. Epoxy
	6. Stainless
	7. Tiers ( )   12"       18"     24"
	8. Other: