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RFQ Form

Please fill all mandatory fields marked with *

COMPANY NAME *

REQUESTED BY (ENTER FIRST NAME) *

REQUESTED BY (ENTER LAST NAME) *

EMAIL ADDRESS *

PHONE *

REGIONAL SALES MANAGER *

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DETAILED PROJECT NAME *

PROJECT PHASE # (IF APPLICABLE)

PROJECT LOCATION *

PROJECT BID DATE *

QUOTE REQUIRED BY *

PROJECT INSTALLATION DATE (ESTIMATED) *

Market Segment *

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APPLICATION *

APPLICATION TYPE *

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PIPE TYPE(S) *

(1) Size:

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Quantity:

(2) Size:

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Quantity:

(3) Size:

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Quantity:

(4) Size:

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Quantity:

(5) Size:

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Quantity:

(6) Size:

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Quantity:

HOW PIPE AND FITTINGS ARE JOINED *

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Pipe Supplier

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INSULATION THICKNESS

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JACKET MATERIAL

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JACKET THICKNESS

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NUMBER OF HEAT TRACE CONDUITS

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IS HEAT TRACING REQUIRED? * YES NO

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ADDITIONAL NOTES

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