ORDER FORM

               

Dealer Information

Customer Information

Service Dealer Information

Order Information

Quantum Model NumberQTYAC
Voltage
Charging TypeMulti
Voltage
24V Batt
AH
36V Batt
AH
48V Batt
AH
80V Batt
AH
Connector
Type
Cable length

Customized Order

DefaultCustom
BATTview ModelQTYBatt AHBatt
Voltage
Charging Type

Customized Order

DefaultCustom
Battery IDBattery S/NBattery ModelTruck IDInstallation DateManufacturing Date

Purchase Orders will not be accepted without facility plan view drawings or ACT personnel walk through and approval from ACT Application Engineering Team.

Facility Information

Quantum ChargersBATTviews

Operation / Work Schedule


Day
Shift
Start Time
Shift
End Time
Shift
Start Time
Shift
End Time
Shift
Start Time
Shift
End Time
MON
TUE
WED
THU
FRI
SAT
SUN

Alerts Settings


Please include Email address to receive site alerts (users must be registered on Act-view.com)

Battery Warranty Information


Please list the Battery ID and Battery age to adjust battery life estimation

Battery IDBattery Age (in months)Battery IDBattery Age (in months)

List of Chargers on site:

BrandModelQuantity
Special Comments: