VERTICAL LIFT QUOTE REQUEST FORM
Thank you for your interest in our vertical lifts. To request a quote for a vertical lift
that best suits your needs, please complete the form below.
Someone will contact you within 24 hours.
* denotes a required field
NOTE: Use the "Tab" key or your mouse to move between fields.

*Contact Name:
 *Email Address:
Phone:
 Fax:
Shipping Info: (For freight purposes)
Company Name
  
Address 1:
 Address 2:
City, State Zip/Postal Code:
 Country:
1) What do you need your VRC do do?                     
2) How often will it be used 
3) Weight capacity:
LBS. 		4) Carriage size: (inches)
 		5) Loading/Unloading method:
6) Travel height:
IN.		 7) Power available:
8) Additional notes

L.K. Goodwin - 20 Technology Way - West Greenwich RI 02817
Inside RI: 401-781-5526• Toll free: 800-343-2478
Fax: 401-781-2880