SL Power Application Road Map Form
Customer Information
*
Company Name:
Address:
City
State/Providence
Zip
*
Country
*
Phone
Web
*
Contact Name
Title
*
Contact Phone
*
Email
Field Sales information
Sales Rep Group:
Sales Rep Name:
Phone:
Email
Distributor:
Distributor Salesperson:
Phone:
Email
Opportunity Information
Customer's Market
Communications / PoE
Computer / Computer Peripherial
Medical
Instrumentation
Industrial / Aero / Military
Wireless
End Application/Customer's Product
*
Description (Be specific and detailed):
*
Program Name:
*
Roll-out Date:
Competition/Target Pricing
New Program?
Yes
No
2nd Source?
Yes
No
Target Price:
Competitor's Name(s)
Quotation Due Date
Budget:
Firm:
Sample Requirement
Quantity:
Due Date:
Pre-Production Requirement
Quantity:
Due Date:
Production EAU
Year 1:
Year 2:
Year 3:
Year 4:
Product Requirements/Information
Spec Sheet Available
No: If spec sheet is not available, complete the Product Requirements / Information section
Yes - Upload File
Type of Power Supply
Internal Open Frame
Internal Enclosed
Linear Power Supply
Exteranal Switch-Mode
External Linear
Transformer
Automotive Adapter (Mobile)
Battery Charger (complete below)
Battery Chemistry:
Cyclic
Stand-by/Float
Battery Voltage
Ahr
# of Cells:
Other (list below)
Input Voltage
100VAC
120VAC
220VAC
230VAC
240VAC
Universal (90-265)
13VDC (Mobile)
Other
Input Frequency
50Hz
60Hz
47-63Hz
47-440Hz
Output Cable Assembly
Cord Length:
Connector #:
Other:
AC/AC Transformer
Center Tap Required?
Yes
No
Mechanical Requirements
L:
W:
H:
Input Connector:
Output Connector:
Wallplug - Check type(s) below
Austrailia
Europe
Japan/North American
UK
Other (Note below)
Desktop
IEC320 "Appliance"
IEC320 "Shaver"
Other
Earth Ground In?
Yes
No
Earth Ground Out?
Yes
No
Output(s)
#1
AC/ DC:
Voltage:
Amps:
Amps Peak:
Watts/VA:
Duration:
Regulation
Other/Comments:
#2
AC/ DC:
Voltage:
Amps:
Amps Peak:
Watts/VA:
Duration:
Regulation
Other/Comments:
#3
AC/ DC:
Voltage:
Amps:
Amps Peak:
Watts/VA:
Duration:
Regulation
Other/Comments:
#4
AC/ DC:
Voltage:
Amps:
Amps Peak:
Watts/VA:
Duration:
Regulation
Other/Comments:
#5
AC/ DC:
Voltage:
Amps:
Amps Peak:
Watts/VA:
Duration:
Regulation
Other/Comments:
Environmental
Safety Agency Requirements
External
IEC Standard # Required:
Meets Energy Star Requirements:
60950-1 -- ITE
Yes
No
60601-1 -- Medical
Internal
Other
Operating Temperature Range:
Agency Marks Required:
UL
Cooling System Air Flow:
TUV
Yes
No
CSA
Amount:
Other:
Fan in Power Supply:
RoHS Compliance Needed?
Yes
No
Yes
No
Comments:
*
Required Fields
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