Please fill in the entire form so that we may better understand your business needs. Please include your company name, your name, title, email address, fill the appropriate information in the drop down box and then type in your comments. When you're finished, click on the "Submit Your Comments" button. All information you share with us will remain confidential.

*Denotes required information
*Company Name:
*Company Address:
*First Name:
*Last Name:
Title (optional):
*Email:
*Phone:
Fax: (optional)
Amici Product(s) interested in:	Envirowrapper Insulated Products Buckles Others		Use "Ctrl" key to make multiple selections.
Describe Company products and function:
Does Company operate:	Own warehouse or production      plant
	Own transportation
	Own wholesale or retail outlets	If yes, how many locations?
Are products currently stretch wrapped:	Manually Stretch wrap machine Automated
Describe product(s) shipped:
Pallet type:	wood plastic other
Pallet size(s):	40"(1016mm) x 48"(1219mm)
	44"(1118mm) x 48"(1219mm)
	46"(1168mm) x 46"(1168mm)
	30"(762mm) x 40"(1016mm)
	Other (type in)
Minimum height of load:
Maximum height of load:
For chilled or frozen commodities:
Current method of protecting products, mark all that apply:	Freezer chests blankets insulated covers multi temp trailers reefer trailer dry ice bulk head dividers plastic bags Others	Use "Ctrl" key to make multiple selections.
Staging or shipping area temperature:		Degrees Fahrenheit Degrees Celsius
Length of time product held in staging or shipping area prior to being loaded into trailer: (hrs)
Shortest distance traveled in terms of time: (hrs)
Longest distance traveled in terms of time: (hrs)
Length of time product held in receiving area at delivery location prior to being placed into cooler or freezer: (hrs)
Temperature in recieving area:		Degrees Fahrenheit Degrees Celsius
Minimum height of load:
Maximum height of load:
Reefer temperature setting:
winter:		Degrees Fahrenheit Degrees Celsius
spring:
summer:
fall:
Comments - please provide any other pertinent information you feel necessary.