CUSTOMER INFORMATION Date Submitted: Company Name: Contact Name: Street Address: Title: Product Design Team City: Phone: State: Zip: Country: USA Email: CA PRODUCT INFORMATION X New Product Type of Device: Next generation of existing product Replace existing product Customer Product/Project Name: Other Comments: Estimated Product Launch Date: Estimated Annual Usage: Target Price: not yet indicated/will not divulge Estimated Commercial Lifetime of Product: NDA Signed : Yes Scope of Work Request Needed : Battery Schedule Dates Quantity Turnkey Design First Prototypes: QTY: Cell Spec Required Date : x Electrical Design Qual Samples: QTY: x Pack Spec Required Date : Mechanical Design Quote Required Date : Pre-Production: QTY: Customer provides electrical design Competitive Info: Full Production QTY: x Customer provides mechanical design TECHNICAL REQUIREMENTS ELECTRICAL MECHANICAL Value Units Battery nominal operating voltage Battery weight target Grams Volts Battery cutoff voltage Plastic Metal Shrink-wrap Other: Pack enclosure type: Volts Battery capacity target Ah Material type Ah or Wh Product maximum discharge rate Chemical resistance mAh/Amps/Watts Duration of maximum discharge rate Vibration / Shock / Drop Sec/min Nominal load Flammability requirement mAh/Amps/Watts Desired charge rate Connector type mAh/ Amps Cycle life required or expected Cycles Water ingress (IP rating) Min/Max operating temperature Deg C Cyclic or backup Application Sterilization procedures (Sterrad, Autoclave, etc) Service life expectation after put in use yrs Comments:
CUSTOMER INFORMATION Date Submitted: Company Name: Contact Name: Street Address: Title: Product Design Team City: Phone: State: CA Zip: Country: USA Email: PRODUCT INFORMATION Type of Device: X New Product Next generation of existing product Replace existing product Other Customer Product/Project Name: Estimated Product Launch Date: Comments: Estimated Annual Usage: Target Price: not yet indicated/will not divulge Estimated Commercial Lifetime of Product: NDA Signed : Yes Scope of Work Request Needed : Battery Schedule Dates Quantity Turnkey Design Cell Spec Required Date : First Prototypes: QTY: x Electrical Design x Pack Spec Required Date : Qual Samples: QTY: Mechanical Design Quote Required Date : Pre-Production: QTY: Customer provides electrical design Competitive Info: Full Production QTY: x Customer provides mechanical design TECHNICAL REQUIREMENTS ELECTRICAL MECHANICAL Value Units Battery nominal operating voltage Volts Battery weight target Grams Battery cutoff voltage Volts Pack enclosure type: Plastic Metal Shrink-wrap Other: Battery capacity target Ah Ah or Wh Material type Product maximum discharge rate mAh/Amps/Watts Chemical resistance Duration of maximum discharge rate Sec/min Vibration / Shock / Drop Nominal load mAh/Amps/Watts Flammability requirement Desired charge rate mAh/ Amps Connector type Cycle life required or expected Cycles Water ingress (IP rating) Min/Max operating temperature Deg C Cyclic or backup Application Sterilization procedures (Sterrad, Autoclave, etc) Service life expectation after put in use yrs Comments: