Name: Modern Industries
Address: 613 W 11th St, Erie, Pa, 16501
Telephone: (814) 455-8061

Corporate Office
613 W 11th St
Erie, Pa 16501
Ph: +1.814.455.8061
Fax: +1.814.453.4382
Email Us: sales@modernind.com
Email Heat Treat: mhtcs@modernind.com
Email Testing Laboratory: labsales@modernind.com
Email Products Division: mpwerSales@modernind.com
Careers/Job Inquiries: personnel@modernind.com

1. Contact Information
Contact Information
Name
Company
Address
Address 2
City/Town
State/Province
Zip/Postal Code
Country
Email Address
Phone Number
2. Please describe the general nature of your shock application:
3. Which of our shock absorbers would best work for you application?
4. Is your interest to replace a shock used in a current application? If yes, what shocks are you using now?:
5. Is your interest for a newly designed product? If yes, is the design completed?
MM slash DD slash YYYY
6. How soon do you require shock absorbers?
MM slash DD slash YYYY
7. What is your expected yearly requirement?
8. Has your company used shock absorbers before?

Functional Specifications:
9. What is the weight to be stopped?
10. What is the velocity of the load when the shock is engaged?
11. What is the direction of travel for the load to be stopped?
12. Is the load powered?
13. If yes, at what force?
14. Shock absorber must stop the load in what distance (inches)?
15 . What is the type of shock absorber action?
16. What is the cycle frequency of the shock's operation?
17. What is the operating temperature range?
18. How much space is available for mounting the shock?
19. File Attachment
Max. file size: 50 MB.

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