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Positive Displacement Pumps
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Quotation Request Form

Magnetically-Coupled Pumps

We will reply to your request within two business days.

Information About You * - Fields Marked with Asterisks are Required
*Name: Title:
*Company: *E-mail:
Address:
City: State:
*Zip/Postal Code: *Country:
*Phone: Fax:

Fluid Information
*Fluid Name:
Concentration:
Viscosity: cps cst ssu
Specific gravity:
Operating Temp: F C
Any Solids? yes no unknown
Solids description (size, %, matl, etc...)

Application Information
*Flow Requirements:
Inlet Pressure:
Discharge Pressure:
Differential Pressure:
NPSHA Available:
System Pressure:
Inlet Flooded? yes  no   unknown

Pump Information
Pump Style:
Material of construction:
Bypass Valve? yes no unknown
Replacing an existing pump? yes no unknown

If so, describe existing pump (mfgr., model no., current problems, etc...)

Drive Information
Motor Voltage:
Motor Type:
Phase:
Motor Enclosure:
Power: HP Watts
Amps:
Speed: rpm
Variable Speed Controller Required? yes no unknown
Other Motor and Controller Information: (i.e.frame size, inverter duty, signal following, etc.)

Other
Comments:
Qty pumps needed:
Date Pump(s) Needed:

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