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MACHINERY QUOTATION REQUEST

Many variables exist in the selection of metering/dispensing equipment. Your co-operation in furnishing the information requested will help us greatly in recommending the equipment best suited for your application.

Fields with asterisk (*) are required.

Name*:
Title:
Company*:
Address 1:
Address 2:
City:
State/Prov:
Zip/Postal:
Phone*: Fax:
E-Mail*:
Company Profile:
APPLICATION DATA:
I am dispensing a single component material
I am dispensing a dual component material..
I AM APPLYING:
Microdots
Size
Dots/Min
Drops
Size
Drops/Min
Beads
Size
Inches/Min
Shots
Size
Shots/Min
Other(encapsulate, etc)
CHEMICAL DATA:
DUAL COMPONENT SINGLE
COMPONENT
RESIN
(PART A)
CATALYST
(PART B)
  Manufacturer's Name
  Manufacturer's Product No.
  Viscosity at Rm Temp
  Specific Gravity or Density
  Filler Type, if any
  Mesh Size of Filler, if any
  Does Filler Settle?
  Heat for Processing?
  Is Material Corrosive?
  Is Material Hygroscopic?
  Reservoir Size Required
  Weight Ratio
  Volumetric Ratio
  Pot Life
Applying Experience ... Dispensing Solutions
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