Customer Contact Form


Product Information

Customer Information




Decision maker on the purchase of the equipment

Ensure that there are no spaces at the beginning or end of the email address.

Opportunity/Quote Information

Can be equipment duty, project, end user, etc.


Can be equipment duty, project, end user, etc.




Channel Partner Contact

Channel Partner Contact

Ensure that there are no spaces at the beginning or end of the email address.








Pump/Blower Type

IF THERE IS NOT ENOUGH ROOM TO DETAIL IN ANY FIELD, THE DESCRIPTION OF OPPORTUNITY FIELD CAN BE USED OR A FILE UPLOADED TO PROVIDE MORE INFORMATION.
Application Data

Include units.

Include units.

Include units.


Include units.

Non-hazardous, Class 1 or 2, Division 1 or 2, Group A, B, C or D. T code if applicable.


Above sea level. Include units.
Liquid Ring Pump Info






Dry Screw Pump Info




Claw Pump Info



Vane Pump Info



RunTech Pump Info



Steam Ejector Pump Info

Include units.

Include units.

Best Pump Info










Include units.

Include units.


CF Multistage Blower Info







Above sea level. Include units.

Include units.

Include units.


Turbo Blower Info






Above sea level. Include units.

Include units.

Include units.


PD Package Blower Info






Above sea level. Include units.

Include units.

Include units.


Type of Sale
Please submit a separate form if you require multiple types of sale.
Pump Technical Information












If Mechanical Seal Furnished by Customer is selected, a drawing must be submitted.

New Parts / Repair Kit Technical Information



Include part number(s) or schematic number(s) if known, or a description of the part.

New Pump Technical Information


If Test Number is unknown, input "NA". If not a replacement pump, input "NA" and provide operating conditions in the Special Requirements section at the bottom.






CL series and 904 series only.

As viewed from drive-end shaft extension.




If Mechanical Seal Furnished by Customer is selected, a drawing must be submitted.

Ejector or Ejector Parts




Other Special Request

Contractor Information - If Applicable




Site Information - If Different from Customer Information






Service Information





Equipment Information




Type of Sale
Blower Technical Information










Use 'ctrl + left click' to select multiple options.


Blower Technical Information



Blower Technical Information