Request for Quote Thank you for giving PSE this opportunity to provide you with a quote for the services you need. Please provide the following product information. Please keep in mind that the more information we have on your product the more accurate we can be in providing you the service that will meet your needs. If you have any questions or need any assistance with the form please don't hesitate to call us at 352-588-2209, ext 102 or email us at pse@pseinc.com. Contact Information First Name: Email Address: Last Name: Phone: Job Title: Fax: Company Information Company Name: Web Site: Address: Country : City: How did you find us? Select... Conformity Direct Mail Google Thomas.net Yahoo State: Other: Zip/Postal Code: Referral: Identifying Test Requirements What Countries or Regions would you like to Market your Product in? US Canadian European Japan Australian Global List any specific countries or regions, other than checked off above, where you would like to market this product. How Long will this product be on the market (life cycle)? Select... 1 year 2 years 3 years 4 years 5 plus years What is the primary intended use environment for your product? Select... Residential Commercial Light Industrial Heavy Industrial Hospital Other Other: Category for the product: Select... ITE Transmitter Sound and television broadcast receivers and associated equipment Medical Test and Measurement In vitro Laboratory Alarm Household appliance Lighting Audio Video Audio-visual and entertainment lighting control apparatus for professional use Power Line Modem Machinery Other Other: Marks of immediate interest: Select... Australia/New Zealand European CE FCC Japenesse VCCI TUV US Safety Marks Others Other: Marks, Listings, certifications of future interest: Select... Australia/New Zealand European CE FCC Japenesse VCCI TUV US Safety Marks Others Other: Do you have any existing approvals: Select... CE FCC TUV UL Other Other: Product Information Product Name: Give a brief description of the functions that your device performs: or Prototype/Engineering Development Name: Model Number(s): Are there any peripherals required to configure system? Select... Yes No If yes above list peripherals required: If more than one model is listed above describe the differences between each model: How many unique configurations are to be tested? Select... 1 2 3 4 How many Modes of operation exist? Select... 1 2 3 4 Approximate set-up time for your device (in Hours): Select... 30 minutes or less 1 hour or less 1 hour or more Approximate weight: Web link to brochure or photo of product(s): Select... 0 - 50 Pounds 50 - 100 Pounds 100 - 200 Pounds 200 - 500 Pounds 500 - 1000 Pounds Over 1000 Pounds Primary material used for the enclosure: Rough Dimensions (L X W X H in inches or millimeters): Select... Plastic with metallic paint Plastic Metal X X Power Requirements Power Supply: Select... AC AC/DC Power supply DC Battery Voltage for EUT? Select... 120-230V auto 120/230V manual switch 120V 230V If Battery Power is it? Other: Rechargeable Non-rechargeable Amps draw during operation: Can product operate during charging? Max or peak amps draw: Select... Yes No Frequency: Select... 50/60 auto 50/60 manual switch 50 Cycle 60 Cycle Power type: If Three phase, indicate: Select... Single Phase Three Phase Select... Delta Wye (Y) Other Number of Power Cords: Software Platform: Select... WIndows 98 Windows XP Vista Mac Linux Other Type of power cord connection: Select... Detachable Fixed Wiring Terminals Software Platform (Other): Frequency of Clock Oscillators in your system: Highest frequency used or generated in your system: How many unique interface cables are not functionally limited to less than 3 meters in length? Number of unique interface cables/IO: Please indicate any telecommunications ports on your product: RJ11 T1/E1 DS ISDN Ethernet Other: Is this your first experience with EMC compliance testing: Select... Yes No Are you interested in pre-testing or EMC design consultation services? Select... Yes No
or Prototype/Engineering Development Name:
If yes above list peripherals required:
How many unique configurations are to be tested? Select... 1 2 3 4 How many Modes of operation exist? Select... 1 2 3 4 Approximate set-up time for your device (in Hours): Select... 30 minutes or less 1 hour or less 1 hour or more