Company Name
____________________________________________________________
Address __________________________________________________________________
City/State/Zip
______________________________________________________________
Tel _____________________ Fax ____________________ Email
____________________
Application Name
___________________________________________________________
Current Supplier
____________________________________________________________
Supplier's Part Number
_______________________________________________________
Annual Usage ___________________________ Current Cost
_______________________
Actual Performance Requirement:
Flow _____________ (CFM) (SCFM)
Type of Application and Value Pressure _____________ Vacuum
___________________
Electrical requirement (Voltage, AC or DC, 3 or 1 phase)
___________________________
Open or TE Motor Enclosure ______________________
Maximum Ambient Temperature ___________________
Maximum Intake Temperature _____________________
Continuous Duty or Intermittent Duty _______________
Duty Cycle, specify if load varies during a complete duty cycle.
Indicate minimum and maximum load and indicate the period of time for one
complete cycle. Include the length of any idle period of time.
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Reason for considering another supplier?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Additional comments that would help us to provide a meaningful proposal?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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