Project Quotation

Contact Information:

Company Name:

Contact Name:

Street Address:

PO Box:

City:

State:

Zip:

Country:

Phone:

Fax:

E-mail:

Profession:

Select Architect CommercialEndUser Contractor DepartmentofTransportation Developer Engineer LightingConsultantDesigner PurchasingAgent ResidentialEndUser Utility Other

* Fields in BOLD are required.

Project Quotation Information:

Project Name:

City:

State:

Country:

Poles (general information):

Number of poles:

Pole height:

Wind Load (80, 90 or 100 MPH):

Options: Lighting Poles

Type of arm needed:

Type of base required:

Options: Floodlighting Poles

Service Basket Type:

High Mast Lowering System:

 Yes No

Luminaire Brackets:

Cross-Arms:

Steps:

Climber Assembly:

Type of Base:

Select AnchorBase EnclosedHBase

Pole Finish:

 Weathering Steel  Galvanized  Factory Finish Paint Coat Prime Coat

Options: High Mast Poles

Pole Base:

Select AnchorBase EnclosedHBase

Pole Finish:

 Weathering Steel  Galvanized  Factory Finish Paint Coat Prime Coat

Luminaires:

Type of Fixture:

Manufacturer of Fixture:

 Mfg. Part Number:

EPA of Fixture:

Number of Fixtures:

Weight of Fixtures:

Additional Comments:

Comments:

Note: Send drawings or specifications, if available, to:

Millerbernd Manufacturing Company
622 6th Street South, P.O. Box 98
Winsted, Minnesota 55395
dclark@millerberndmfg.com