Required fields are indicated
Name
Job Title/Position
Telephone Number
Email
Company Name
Address
Part Number (if available):
Required Delivery / Due Date:
Quantity:
Inside Diameter (ID): Face to Face (FF) Dimension:
Expansion Joint:Single ArchMultiple ArchLightweightOther
Concentric Reducer:
ID x
ID x Face to Face Length
Eccentric Reducer:
SleeveEnlarged FlangeFilled ArchOpen Arch
Flue Duct / Fan ConnectorPump
Cover Material:—Please choose an option—ButylChloroprene / NeopreneCPEEPDMNitrileMil Spec Neoprene®PTFE / Teflon®Other
Color:
If "Other" specify:
Tube Material:—Please choose an option—ButylChloroprene / NeopreneCPEEPDMNitrileMil Spec Neoprene®PTFE / Teflon®Other
No. of Open Arches:
No. of Filled Arches:
1st Flange OD: OD
150 LBS300 LBSOther
2nd Flange OD: OD
Split Metal Retaining Rings: YesNo
Type: Stainless SteelCarbon
# of Ring Sets:
Size of Rings:
Comments
Upload drawing if available (not required)
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