Quotation Worksheet


CONTACT INFORMATION  
CUSTOMER *Name     *Date
Address     Apt, Suite or Unit No.
(* = Required) City     State     Zip
  *Phone     Fax    *E-Mail
VEHICLE INFORMATION  
VEHICLE *Make     *Model     *Year
TRANSMISSION *Manual     Automatic     *Number of Speeds Forward
ENGINE *Number of Engine Cylinders     * Original HP or Displacement
CONVERSION REQUIREMENTS
PERFORMANCE *Performance Desired Top Speed (mph)     *Desired Range (mpc)
  Speed or Acceleration-Oriented     Range-Oriented     In-Between
TERRAIN * Flat     Slightly-Hilly     Moderately-Hilly
WINTER TEMP 0-15F   16-25F     26+F     Garaged   Yes    No
CHARGER * 120 VAC Input     * 240 VAC Input
ACCESSORIES 900RB Fuel Gauge: Yes     No  
  * Power Brake Vacuum: Yes     No  
  * Power Steering: Yes     No - Drive From Driveshaft: Yes    No
  Air Conditioning: Yes     No - Drive From Driveshaft: Yes    No
  * Double-Shafted Motor Required: Yes     No  
  * Electric Heater/Defroster: Yes     No  

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