background image

 

 

 

 

Item 

Quantity 

Part code 

Designation 

12 

888.131 

Actuating magnet 

 

 

 

 

 

 

230 V 

– 50/60 Hz – 1phase 

 

9.2.6  Electric equipment 

 

 

Item 

Quantity 

Part code 

Designation 

888.698 

Closing contact maker 

888.699 

Opening contact maker 

800.053 

Main power switch 

QXWA 

Selector / selector switch 

AT 

Contact maker 

8.12.031 

Mounted housing 

888.229 

Sleeve insert, 4-pole type 

Summary of Contents for ET4400

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Page 2: ...German Date of revision 2022 10 05 Version 1 0 Copyright by UNIFLEX Hydraulik GmbH Technical modifications reserved The reproduction distribution and utilization of this document as well as the communication of its contents to others without explicit authori zation are prohibited Offenders will be held liable for the payment of damages All rights reserved in the event of the grant of a patent util...

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Page 4: ...ch Strasse 50 52 D 61184 Karben The following standards codes and specifications have been applied EC Directive 2006 42 EC EMC Directive 2014 30 EC EN ISO 12100 2010 EN 60204 1 2018 UK Supply of Machinery Safety Regulations 2008 UK Electromagnetic Compatibility Regulations 2016 This declaration are invalid when the machine is modified or if unau thorized and unapproved third party components are u...

Page 5: ...ed by noise 14 2 3 5 Risks imposed by substances 14 2 3 6 Risk by hot surfaces 14 2 3 7 Risks in case of fire 14 2 4 Safety 15 2 4 1 Working area 15 2 4 2 Emergency Stop 16 2 4 3 Protection equipment 16 2 4 4 Warning signs on the machine 17 3 Machine description 19 3 1 Design and function 19 3 2 Accessories 20 3 3 Forming process 21 3 4 Operation and display elements 22 3 5 Foot pedal accessory 23...

Page 6: ...mediate dies 42 5 5 1 Changing the crimping dies with the quick die change system only profile 239 45 5 6 Setting the forming dimension 48 5 7 Forming travel limitation 48 5 8 Stop 49 5 9 Emergency stop 49 5 10 Cleaning 50 6 Maintenance 51 6 1 What you have to observe 51 6 2 Maintenance schedule 51 6 3 Hydraulic oil change 54 6 4 Checking and replacing slide bearing plates 56 6 5 Micrometer adjust...

Page 7: ...c equipment 70 9 2 6 Electric equipment 71 9 3 Spare parts kit 73 9 4 Service tool 73 9 5 Retaining bolt for standard crimping dies depending on crimping die 74 9 6 Hydraulic diagram 76 9 7 Electric diagram 77 9 8 Maintenance log 79 9 9 Declaration of qualified staff 81 ...

Page 8: ...ness of risks and hazards in compliance with all notes included in this Operation Manual The machine unit may only be operated by staff who has read the Operation Manual has understood it has been instructed in the operation of the machine unit and has signed in the Annex Figures may include accessories options Customer specific equipment may vary The product images shown are for reference only an...

Page 9: ...m and fighting means Free access to this equipment must be ensured personal protection equipment is worn safety footwear pro tection gloves and safety glasses Machine unit fitters Machine unit fitters must be at least 18 years old and have com pleted training for the task i e they must have attended a specialist vocational training A fitter must observe the instructions in the Operation Manual mus...

Page 10: ...all times Upon disposal of the ma chine unit the Operation Manual must also be handed over 1 3 Name plate The name plate is fixed near the power cable 1 4 Voltage codes Voltage variant Voltage rating 230 230 V 50 60 Hz 1 phase 380 380 V 50 60 Hz 3 phases The machine voltage is indicated on the name plate ...

Page 11: ...ult in light injuries This warning is supple mented by a triangular hazard symbol The signal word ATTENTION identifies a potentially hazardous sit uation in which the product or property in the environment may be damages This warning is supplemented by a hazard symbol or a exclamation mark 2 2 Intended use This machine is a forming machine for industrial use only suitable for the manufacture of ho...

Page 12: ...sidered as being not in compliance with the in tended purpose in particular design modification of the machine use in explosive environments forming of non metal workpieces without specific safeguards approved by UNIFLEX misuse of consumables and waste materials In particular non metal workpieces may by overstressed by the for ming process so that this may result in a sudden failure Chips or serio...

Page 13: ...e is a risk of electrocution near the live parts Work on electric systems may only be performed by qualified electricians or instructed and trained persons under the super vision of a qualified electrician Deactivate the machine unit and secure it against unintentio nal restart before maintenance 2 3 3 Risks imposed by hydraulic equipment Risks are imposed by all hydraulic lines and connections Hy...

Page 14: ... machine unit owner must provide for appropriate protection e g instruct staff to wear ear protection provide information instructions on risks identify hazardous areas provide health monitoring 2 3 5 Risks imposed by substances Oils greases and emulsions may penetrate the skin When hand ling hazardous substances oils and greases the manufacturers safety instructions have to be observed Apply skin...

Page 15: ... safety data sheet of the hydraulic oil supplier 2 4 Safety 2 4 1 Working area The working area is defined as the area 1 metre all around the ma chine shaded Keep the working area free from trip hazards Use ducts for lines and cables Provide good illumination Keep access to hydraulic supply free ...

Page 16: ...tomer specific workpieces UNIFLEX is not capable of supplying additional standard protection equipment to gether with the machine for the prevention of potential residual risks imposed by the machine The necessity of additional workpiece specific protection equip ment may for instance arise for angled workpiece geometries need ing a large opening for being inserted into the forming machine The pre...

Page 17: ... before commissioning of the machine UNIFLEX will provide you with customized solutions for protection equipment upon request Please do not hesitate to address your personal contact for consultation Mounted safety equipment must not be removed bypassed or avoided 2 4 4 Warning signs on the machine Hand injury on the die system Risk of squeezing on the die system ...

Page 18: ...Oiling greasing prohibited on the die system Illegible or missing warning signs must immediately be replaced by the owner ...

Page 19: ...on selector switch foot switch button 6 Socket for double foot switch only PS 2 Double 7 Micrometer 8 Crimping tool The crimping tool 8 is closed hydraulically whereby the work piece is formed The pressure needed for this purpose is built up by the electrically driven pump 2 in the cylinders Depending on the operation mode the actual forming process is controlled via the buttons on the control pan...

Page 20: ...iate dies if present are attached to the base dies 1 The intermediate dies are required if small work pieces are to be formed on a large machine After the forming process the base dies are pressed apart by the pressure springs 2 when the tool opens The bearing segments 3 on the front guide the base dies axially in the tool 3 2 Accessories The machine may be fitted with accessories A list of the av...

Page 21: ...ces may by overstressed by the forming process so that this may result in a sudden failure Chips or seriously accelerated workpiece parts impose a high risk po tential for operators individuals and objects even outside the working area Relevant workpieces should only be formed using specific safeguards ATTENTION Risk of damage to machinery The machine lifetime is reduced with a high permanent load...

Page 22: ...3 4 Operation and display elements 1 Close tool button 2 Main switch emergency stop button 3 Open tool button 1 Operation via button 2 Operation via double foot switch ...

Page 23: ...ket for double foot switch PS 2 Double When an automatic end stop is connected the crimping tool is opened by means of the Open tool button 3 5 Foot pedal accessory 1 Close machine pedal 2 Open machine pedal ...

Page 24: ...re may result in work related musculosceletal disor ders and reduce productivity Make sure that operators have sufficient periods of relief and recreation 3 6 End stop accessory 1 Clamp lever 2 Sleeve 3 Plunger 4 Stop pin 5 Clamp 6 Guidance 7 Sleeve ...

Page 25: ...oise level 70 dB A Protection class IP 40 Function Forming force 2000 kN 200 t Max forming range Ø crimping dies 17 mm max outside diameter of the fit tings before the forming process Maximum Ø crimping dies 92 mm Opening size without dies 147 mm Opening distance 45 mm Closing speed 4 1 mm s Forming speed 2 0 mm s Opening speed 7 0 mm s ...

Page 26: ...itting 4SH 2 Part fittings 2 depending on the fitting Industry 3 90 bend 2 depending on the fitting Die type 266 Electrical connection Power rating 4 kW Voltage rating adjustable See Voltage code in Section 1 Back up fuse 20 A delayed preferably thermal fuses if circuit breakers are used these should be of the class C type ...

Page 27: ...rkbench Stable level workbench with a carrying capacity of approx 500 kg We recommend industrial flooring which meets the following structural requirements Permanent floor loading Approx 0 07 kg mm2 Floor carrying capacity Min 2500 kg m2 Floor quality B25 Evenness Max unevenness 5 mm m Inclination max 5 mm m Ambient conditions Ambient temperature 10 o C 35 o C Air humidity 45 65 The data are theor...

Page 28: ...ydraulic oil with improved properties and addi tives can prolong the service life of the machine and extends the oil change interval Information and assistance for the oil analysis can be provided by you local oil supplier ...

Page 29: ...secured safely within the packaging All applicable laws and regulations relating to securing loads shall be ob served during transport The machine must only be unloaded and transported with a crane Lifting gear with a sufficient length width and lifting capacity must be used For machine weight please refer to Technical data in Section 3 ...

Page 30: ...pursu ant to DIN EN 1492 1 with a width of 120 mm through the crimp ing tool The lifting belt must be placed around the crimping tool in such a manner that it supports with its full width 9 Use the crane to lift the machine with the lifting gear and trans port it to the installation site 4 2 Intermediate storage of machine unit If the machine unit cannot be mounted immediately upon delivery it mus...

Page 31: ...machine for damage 4 Check the electric cables for damage 5 Train the operating staff and record training sessions in Decla ration of trained staff Section 9 WARNING Risk of injuries Machine components might loosen during transport Such com ponents might be flung out during to the forming process There is a risk of being injured Open and close the machine several times without any work piece Check...

Page 32: ...liquid spills impose a danger of slipping and falling Observe supplier s protection and safety instructions see data sheet Wear personal protection equipment Do not eat drink or smoke in the working area and when handling consumables Ensure good ventilation Avoid floor contamination ATTENTION Risk of fire Hydraulic liquid spray or spills impose a risk of fire Avoid ignition sources welding cutting...

Page 33: ...trician Have the power cable of the machine connected to the local mains by a electrically qualified person according to the regu lations of the Electricity Board Do not operate the machine without a sufficiently rated ground wire Before performing maintenance work switch off the machine and secure it against switching on unintentionally 1 Disconnect the power supply for the machine and secure it ...

Page 34: ...rolonged operation of the motor with an incorrect rotational di rection or operating the machine without oil will destroy the hyd raulic pump Make sure that the amount of hydraulic oil in the machine is sufficient before starting the machine ...

Page 35: ... hydraulic system 1 Switch on the machine 2 Operate the machine in the idle mode for two minutes in order to fill the pump with oil 3 Open and close the tool several times 4 Check oil level add hydraulic oil if required ...

Page 36: ...g operation Observe the safety instructions on the machine unit Make sure that no other persons stay in the working area Use appropriate aids to handle heavy workpiece Each movement of the hand must be observed The control cabinet must be closed securely Eating drinking and smoking at the workplace is prohibited Wear close fitting clothes Do not wear watches or jewellery 5 2 Start 1 Check that the...

Page 37: ...rectly mounted in the tool The forming dimension is set correctly please also refer to Set ting the forming dimension Section 5 Preferably form the workpiece in the centre of the crimping die length Eccentric forming will result in a conical forming result and increased lopsided wear on the die system and the bearing plates 5 3 2 Operation mode buttons control panel ...

Page 38: ...ming pro cess starts and ends when the pre set diameter pressure is reached 4 Press the button upon completion of the forming process to open the tool 5 Remove the workpiece from the tool 6 Check the forming dimension after the first forming process Correct the forming dimension in case of deviations between the actual dimension and the specified dimension see Setting the forming dimension in Sect...

Page 39: ...te the double foot switch 2 Manually position the pre mounted work piece in the tool 3 Hold the work piece with one hand during the forming process 4 Activate and hold the double foot switch 5 When the forming process is completed release the foot switch Close and activate the foot switch Open to open the tool 6 Remove the work piece from the tool 7 Check the forming dimension after the first form...

Page 40: ...e electrical plate 5 4 Changing the crimping dies 5 4 1 Changing the crimping dies using a die wrench Positioning the crimping dies 1 Close the crimping tool until the holes 5 are visible for using the locking bolt 2 Switch off the machine using the main switch and secure it against switching on unintentionally ...

Page 41: ... set comprises eight crimping dies or seven crimping dies and one matching marking die Removing the crimping dies 1 Close the crimping tool until the holes 5 are visible for using the retaining bolt 2 Switch off the machine using the main switch and secure it against switching on unintentionally WARNING Risk of squeezing When the die system closes there is a risk of getting squeezed between the di...

Page 42: ...ase the locking bolt by slightly hitting on the die wrench 5 5 Replacing the intermediate dies Position the intermediate dies 1 Close the crimping tool until the holes 5 are visible for using the locking bolt 2 Switch off the machine using the main switch and secure it against switching on unintentionally ...

Page 43: ... complete set of identical intermediate dies with the same label and diameter Removing the intermediate dies 1 Close the crimping tool until the holes 5 are visible for using the locking bolt 2 Switch off the machine using the main switch and secure it against switching on unintentionally WARNING Risk of squeezing When the die system closes there is a risk of getting squeezed between the dies Only...

Page 44: ...ng dies PB 239 and QDC 239 the base dies the locking bolts in the base dies as well as the retaining bolts of the intermediate and criming dies will be destroyed Only mount profile 266 268 237 intermediate dies individually and manually After forming heavy fittings the locking bolt may be slightly slug gish In this case use a mallet to release the locking bolt by slightly hitting on the die wrench...

Page 45: ...les of the crimping dies 2 4 Rotate anti clockwise and remove the crimping dies 2 from the deposit 5 Check the retaining bolts 3 of the crimping dies for damage 6 Hold the quick die change system with crimping dies in the centre of the crimping tool WARNING Risk of squeezing When the die system closes there is a risk of getting squeezed between the dies Take care that no parts of your body are ins...

Page 46: ...rmediate dies and the spring mounted pressure pieces must engage into the retaining bolts 8 Remove the quick die change system 1 and check that the crimping dies fit tightly 9 Proceed in reverse order to remove the crimping dies For machines with a basic die system different from PB 239 the intermediate dies must be inserted as instructed The QDC 239 5 may only be used to insert or remove the crim...

Page 47: ...hine will be damaged see X in the figure In the figure the crimping die 2 is placed incorrectly Place the crimping die 2 in the intermediate die 3 so that it does not protrude In the figure the crimping die 1 is placed correctly 1 Socket for double foot switch PS 2 Double When an automatic end stop is connected the crimping tool is opened by means of the Open tool button ...

Page 48: ...ming dimension less crimping die di ameter 5 Form the workpiece 6 Check the workpiece 7 If the dimension is reached manufacture other identical workpie ces 8 If the dimension is not reached Adjust difference on control and or in the micrometer repeat the forming process and check the workpiece 5 7 Forming travel limitation If the forming process is started outside the maximum forming range see Tec...

Page 49: ...rimping tool and retaining bolts for contamination damage and secure fitting 6 Check the oil level 7 Remove contamination dust and chips using a vacuum Inform the fitter in case of damage or other irregularities 5 9 Emergency stop In case of an emergency Immediately deactivate the emergency stop switch in cases of emergency The crimping tool movement will be stopped The drive unit is shut down ...

Page 50: ...of the emergency stop 2 Activate the emergency stop switch 5 10 Cleaning ATTENTION Risk of damage to machinery If the machine is cleaned with a steam jet or compressed air dirt and water may ingress in the machine and cause serious da mage Do not use a steam jet to clean the machine Do not use compressed air to clean the machine 1 Vacuum the machine from metal abrasion crimping scale in the opened...

Page 51: ...on in Section 5 Use the lock to prevent the main switch from being switched on and also attach a sign Example text Machine unit out of service for maintenance work Do not switch on Welding flame cutting and grinding work on and in the ma chine unit and its environment must be approved in advance There is a risk of fire The machine unit must be cleaned from dust and inflammable substances Adequate ...

Page 52: ...6 Crimping tool Crimping tool Check for damage and wear X Retaining bolt Check for damage X Slide bearing plates Check for wear see Checking and replacing slide bearing plates in Sec tion 6 X Pressure springs between base dies Check for da mage X Check all bolted connections for secure fitting and retighten if necessary 1 Safety equipment Emergency stop button Emergency stop device Check function ...

Page 53: ...Hydraulic oil changes and wear part replacements must be recor ded in the maintenance log ...

Page 54: ...f slipping and falling Observe supplier s protection and safety instructions see data sheet Wear personal protection equipment Do not eat drink or smoke in the working area and when handling consumables Ensure good ventilation Avoid floor contamination ATTENTION Risk of fire Hydraulic liquid spray or spills imposes a risk of fire Avoid ignition sources welding cutting and soldering work near the h...

Page 55: ...ion cap 1 7 Do not operate the machine for a minimum of four hours so that the dirt particles in the system can settle 8 Switch on the machine 9 Operate the machine in the idle mode for two minutes 10 Run the tool several times to bleed the hydraulic oil system 11 Check oil level The oil level can be read on the dipstick of the air ventilation cap The oil level should be in the middle of the marki...

Page 56: ...plates for wear replace defective parts The slide bearing plate 1 is new the slide bearing plate 2 is worn ATTENTION Risk of damage to machinery Worn slide bearing plates may cause damage to the machine and lead to inaccuracies of the forming dimension Replace worn slide bearing plates in good time ...

Page 57: ...g ring 2 4 Remove clamping ring 2 5 Pull out old slide bearing plate 3 6 Insert the new slide bearing plate 3 Replace all eight slide bearing plates in this manner 7 Mount clamping ring 2 8 Tighten the hexagon socket head screws 1 Shims if present have to be inserted at the same position as be fore Check the machine zero point after each bearing plate replace ment and readjust the micrometre if ne...

Page 58: ... the micrometer must be readjusted 1 Release the screws on the cover 2 Remove the cover see Annex in Section 9 3 Loosen the counter nut 1 of the contact screw 2 4 Adjust the contact screw 2 2 5 revolutions of the contact screw correspond to 1 mm change in the forming dimension V 5 Remount the enclosure front panel 6 Test the crimping process and readjust if necessary ...

Page 59: ...Machine forms unevenly coni cally Bearing plates worn Check bearing plates for wear and replace if necessary Base dies damaged Check base dies for damage and replace if necessary Crimping dies damaged Check crimping dies for da mage and replace if necessary Crimping area not centred Preferably form the work piece in the centre of the crimping die length Crimping dimension not achie ved Bearing pla...

Page 60: ...kin eyes respiratory and intestinal tracts Hy draulic liquid spills impose danger of slipping and falling Observe supplier s protection and safety instructions see data sheet Wear personal protection equipment Do not eat drink or smoke in the working area and when handling consumables Ensure good ventilation Avoid floor contamination ATTENTION Risk of fire Hydraulic liquid spray or spills imposes ...

Page 61: ...se the machine unit before dismantling it deactivate the hydraulic pump and secure it against restart operate valve manually if any open bolted hydraulic connections slowly and carefully Check the machine unit for mechanical tension and consider it during dismantling Empty the machine unit of all consumables see Maintenance Section 6 8 2 Recycling The machine unit contains metal hydraulic hoses el...

Page 62: ...Return consumables e g oils greases test media to supplier they are hazardous waste Also observe the information given on the safety data sheet ...

Page 63: ...9 Annex Individual machine unit components may deviate in their features Please indicate the serial number of the machine for spare part or ders ...

Page 64: ...DS F Basic TU QDS F Shelf TU QDS F 239 l End stop TA S6 2 manual Double foot switch PS 2 Double Mirror SHS S6 2 Table machine SHS S6 2 Stand alone machine Camera set OCS 10 3 retro Lamp with magnetic base LUS Die wrench 239 017 4 Universal table only EcoLine and MobileLine TU Crimping dies system PB 239 266 Please contact our Sales department for ordering accessories ...

Page 65: ...ll nut 5 1 set 266 8 Bearing segments 6 1 set 266 5 Bearing plates 8 4 266 390 3 Hydraulic cylinder 9 1 266 213 3 Clamping ring 532 8 798 110128 Cylinder bolt DIN EN ISO 4762 M8x100 533 12 798 120066 Cylinder bolt DIN EN ISO 4762 M6x20 534 8 268 135 4 T nut DIN 508 M6x8 535 8 798 110112 Cylinder bolt DIN EN ISO 4762 M6x25 536 8 798 110098 Cylinder bolt DIN EN ISO 4762 M5x12 ...

Page 66: ...eve Ø 45 Ø 50 length long 1001 8 266 1192 Base dies mounted 266 1190 Complete tool 9 2 2 Basic dies Item Quantity Article code Designation 1 8 266 198 1 Basic dies 2 8 235 008 4 Locking pin 3 8 798 420027 Threaded pin DIN EN ISO 4028 M5x10 4 8 798 420029 Threaded pin DIN EN ISO 4028 M12x16 5 8 D 195A 21 Compression spring ...

Page 67: ...em Quantity Article code Designation 10 1 266 240 1 Chassis Ecoline 11 1 266 243 2 Tank cover 13 1 264 213 3 colour code Cover 15 1 266 224 2 colour code Cover 18 1 777 924 2 Designation sign 25 1 226 051 4 Limit switch attachment ...

Page 68: ... risk warning sign 520 1 578 4 Oil prohibition sign 530 1 716 4 Warning of hand injuries sign 9 2 4 Hydraulic system Item Quantity Part code Designation 1 1 235 326 777 341 Hydraulic block pressure limitation valve 268 325 3_A 268 325 3_D Hydraulic block pressure limitation valve 268 325 3_C 2 1 268 325 3 Hydraulic block complete 3 1 266 359 Hose assembly 4 1 264 351 264 352 H pump EcoLine 3 phase...

Page 69: ...Line 230 V 60 Hz 1 phase Electric motor 4 kW EcoLine 230 V 50 Hz 1 phase Electric motor 4 kW EcoLine 200 V 60 Hz 3 phases 8 2 239 516 Suction filter 9 1 set 263 234 3 Motor attachment 10 1 set 263 233 3 Motor attachment Item Quantity Part code Designation 1 2 245 515 Piston pressure switch pressure setting 40 bar 380 V 50 60 Hz 3 phases ...

Page 70: ...8 699 Opening contact maker 3 1 800 053 Main power switch 4 1 QXWA Selector selector switch 5 1 AT Contact maker 6 1 8 12 031 Mounted housing 7 1 888 229 Sleeve insert 4 pole type 8 1 800 021 Transformer 9 1 8 06 002 Motor protection switch 10 16 A 10 1 15 GQ3 Limit switch 11 1 888 132 Magnetic switch ...

Page 71: ...hase 9 2 6 Electric equipment Item Quantity Part code Designation 1 1 888 698 Closing contact maker 2 1 888 699 Opening contact maker 3 1 800 053 Main power switch 4 1 QXWA Selector selector switch 5 1 AT Contact maker 6 1 8 12 031 Mounted housing 7 1 888 229 Sleeve insert 4 pole type ...

Page 72: ...Item Quantity Part code Designation 8 1 800 021 Transformer 9 1 8 06 147 Motor protection switch 25 10 A 10 1 15 GQ3 Limit switch 11 1 888 132 Magnetic switch 12 1 888 131 Actuating magnet ...

Page 73: ...per set 239 041 4 Retaining bolt steel profile 239 239L 8 per set 239 151 Pressure piece profile 239 239L 8 per set 232 504 4 Retaining bolt profile 266 1 set 266 11 Repair tool set 9 4 Service tool Quantity Article code Designation 1 266 550 Mounting aid ball nut for tool 266 1190 S6 1 266 551 Mounting aid ball nut for tool 266 1195 S6S 1 266 580 Mounting aid slide bearing plate item 6 pressure p...

Page 74: ... standard crimping dies depending on crimping die Retaining bolt Crimping die profile 262 263 239 266 232 237 554 245 246 247 262 104 4 x 262 129 3 x 239 041 4 x 239 041 4 sw x 232 504 4 x x x 232 505 4 Ø96 Ø103 220 502 4 x ...

Page 75: ...Retaining bolt Crimping die profile 262 263 239 266 232 237 554 245 246 247 245 114 4 x x x ...

Page 76: ...9 6 Hydraulic diagram ...

Page 77: ...9 7 Electric diagram 380 V 50 60 Hz 3 phases ...

Page 78: ...230 V 50 60 Hz 1phase ...

Page 79: ...9 8 Maintenance log Hydraulic oil Hose assembly Retaining bolt Slide bearing plate Pressure springs Guiding plate Relay Remark Date Signature ...

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Page 81: ... of the UNIFLEX machine and have been informed on all safety related details In addition I declare that I have read and under stood this Operation Manual completely City Date Name Signature City Date Name Signature City Date Name Signature City Date Name Signature City Date Name Signature City Date Name Signature ...

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