客户需求评估分析表.doc

Application Assessment Form 客户需求评估分析表To better service and assist with your packaging needs, please fill out the following application assessment form and fax back to (732) 564-0444 or email to S. Date日期 : Company Name 客户名称 : _Contact 联系人: _Address 地 址 : _Phone Number 电话: _Fax Number 传真: _Email Address 电邮: _Web Address 网址: _Industry Segment 行业:Pharmaceutical- Aseptic 制药-无菌级Pharmaceutical- Non Aseptic 制药-非无菌级, 外用Cosmetic / Health / Beauty Aids / Personal Care 化妆品,个人护理Food / Pet Food / Beverage / Dairy 食品/ 饮料Chemical / Paints / Industrial Products 化工原料/ 工业制品Application 应用 :Primary Packaging 前段包装机械 Unscramble 理瓶机 Washing/Cleaning 洗瓶机Sterilizing 消毒灭菌 Filling 灌装机 Stoppering/Sealing/Plugging 封口机 Capping/Crimping 旋盖/扎盖机Secondary/Downstream Packaging 后段包装机械Tray Loading 装盘, 入托Labeling 贴标Coding/Marking 喷码Induction Sealing 感应热封Cartoning 装盒Bundling 捆包Case Packing装箱Palletizing 出货栈板Turnkey Packaging Systems 交钥匙工程Special Applications 特殊要求 _Product Description and Type 产品类别（制药、化工、化妆品) : _产品介质特性 : Aqueous 水针剂: _ Viscous 膏剂: _ Stringy 粘合剂: _ Suspension 悬浮剂_ Abrasive研磨剂_ Powder粉剂: _ Other 其它: _ Method Desired 设备类型: Automatic 全自动 Semi-Automatic 半自动 Other其它: _ Machine Type设备类别: Sanitary 无菌级 Non-Sanitary 非无菌级 Other其它: _Fill Accuracy Desired 设精度要求 : Packaging Environment工作环境级别: Class: _ 级 Container Description and Type容器材质 (玻璃、塑料等): _ Other其它: _(Glass, Plastic, etc) # 1 # 2 # 3 # 4 # 5 Volume灌装量: _ _ _ _ _OD 容器外径 (mm): _ _ _ _ _Neck Size 瓶口尺寸(mm): _ _ _ _ _Height 高度 (mm): _ _ _ _ _CPM* 灌装速度 (瓶/分): _ _ _ _ _*Containers per minuteClosing 封口:Stopper or Plug Description 胶塞封口（天然橡胶、硅胶、合成橡胶等）: _(Natural rubber, siliconized, butyl, etc) # 1 # 2 # 3 # 4 # 5 Sizes 胶塞尺寸 (mm) _ _ _ _ _Full or Partial全塞或半塞: _ _ _ _ _ Sealing熔封密封: 铝铂热封_Cap Description: 瓶盖封口（铝盖密封、螺旋盖密封等）_(Aluminum, screw cap, etc) # 1 # 2 # 3 # 4 # 5 Sizes瓶盖尺寸(mm): _ _ _ _ _Electrical 电气参数:Volt电压: _ Hertz 频率: _ Phase 相: _ Explosion Proof 防爆要求: _NOTE: Product and container samples are needed for a firm quotation.附注: 如需正式报价, 请提供产品和容器样品.Carton Dimension 纸盒尺寸: # 1 # 2 # 3 # 4 # 5 Sizes 尺寸 (LxWxH): _ _ _ _ _ Bundle Dimensions捆包尺寸: # 1 # 2 # 3 # 4 # 5 Sizes 尺寸 (LxWxH): _ _ _ _ _ Case Dimension 外箱尺寸: # 1 # 2 # 3 # 4 # 5 Sizes 尺寸 (LxWxH): _ _ _ _ _ Pallet Configuration 栈板尺寸: # 1 # 2 # 3 # 4 # 5 Sizes 尺寸 (LxWxH): _ _ _ _ _ Purchasing Criteria 采购准则:Budgeted Dollars预算: Is the project approved? 是否已经立项Yes 是 No 否Do you have budgeted dollars for the project? 预算是否通过Yes是 $ _Amount美元 Year 时间, 年度: _ No 否Delivery交货期限 :When is the equipment needed? 设备需求时间Why is it needed at that time? 采购时间Buying Process采购流程 : Who approves project? 由谁审批此项目What factors are driving your decision 采购原因 ?New Product Development 新建Replace Existing equipment 改建Upgrade packaging line 扩建Automate the line 提高自动化程度Add Capacity 提高生产量Improve the quality of the product 改进产品质量Improve the line control 改进整线控制Reduce Material costs 降低材料成本Reduce Labor costs 降低劳动成本What will influence the decision 影响采购的因素 ? Existing Cozzoli/ MRM customer 现有客户ISO 9001:2000 通过ISO 9001认证User friendly使用方便Quick Change Over 换型迅速便捷Flexibility 多功能Greater Accuracy 精确度较高Return on Investment 投资回报迅速Delivery 交货迅速After-sales technical support 售后服务Where equipment is manufactured 原产地Price 价格Competition竞争厂家 : Do