H&W CONTROLS
A Division of Henry & Wright Corporation
739 East 140th Street - Cleveland, OH 44110
Phone: 216-851-3750 Fax: 216-851-3970
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BPT-3B "On-Line" Request-for-Quotation Form

If you experience any problems responding to this form, (or if you are not using a
forms-capable browser) you may email your response to: H&W Controls

If preferred... call us directly at: 216-851-3750

We will try to get your quote back to you within one to two business days.

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 Customer's Name and Address
 (All info in this area must be filled in)
*Name:
*Company Name:
*Street:
*City:
*State:
*Zip:
*Phone:
  Fax:
 Email Address: (myname@somedomain.com)
*Company Type: End User OEM Rebuilder *Response Type: Email Phone Fax Postal Mail (with brochures)


 BPT-3B Complete Kit

Yes No  BPT-3B Clutch/Brake Performance Tester Kit*

* The BPT-3B standard kit includes three displays to concurrently read "Minimum Safe Distance", "Stopping Time", and "Clutch Engage Time". Includes all standard components listed below..


 BPT-3B Individual Components (Included in standard kit above) 

Yes No  500728A1A Carrying case with divider tray and label
Yes No  500818A1 10" grid assembly
Yes No  500818A2 20" grid assembly
Yes No  500916A1 Grid holder
Yes No  500712A1 Magnetic base with gooseneck
Yes No  500917A2 Palm Switch Read Head Cable Assembly
Yes No  556500B1A Electronic Unit - BPT-3B (includes Main & Driver Boards)
Yes No      556000B1A Main Control Board Assembly
Yes No      556100B1A Driver Board Assembly
Yes No  500707A2 Power adaptor (12Vdc. - 500 milliamps)
Yes No  OM-150 Instruction manual


 BPT-3B Optional Components (Not included in kit) 

Yes No  500818A3 30" grid assembly (does not fit in carrying case)
Yes No  501918A1 Clutch Trip Read Head Cable Assembly
Yes No  500971A2 Control Readout Cable - 8ft. (works with receptacle below)
Yes No  500961A1A Readout Receptacle, installed in H&W controls

Additional or Special Requirements:



*Requested Delivery Date:
Area Representative:

Number of Above Units: (Discount applies to last unit when purchased within 1 year)

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