Request for Pump Quotation

Request a Pump Quotation

Use this form to request a pump quotation. Items in red are required.

Your Name:
Your Title:
Company Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Your E-mail address:	Example: yourname@isp.com
Area Code and Phone Number: If you're outside of the U.S., please enter your country and city codes.	Examples: 706.863.1011 or 011.39.81.556.7888
Area Code and Fax Number: If you're outside of the U.S., please enter your country and city codes.

Quotation Due Date:	Example: 09/15/01
Equipment Location:
Slurry • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Type of Slurry:
If Type of Slurry is "Other," please specify:
Service Description:
If Service Description is "Other," please specify: (Space limited to 25 characters.)
Solids SG:
Slurry SG or % solids by weight:
Maximum solid size:
Average (D50) solid size:
Normal oversize solid size:
Special characteristic: Include information on pH, temp., viscosity, froth, chlorides...(Space limited to 300 characters.)
System • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Flow:
Head (TDH):
Describe system, pump or application concerns: (Space limited to 300 characters.)
Motor • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Type enclosure:
Phase/hertz/voltage:
RPM speed:
Elevation:
Is variable speed required?
If variable speed is required, what is the variable freqency?
Other special requirements: (Space limited to 300 characters.)
Drive • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Should GIW quote drive?
V-Belt Design:
If V-Belt Design is Fixed Speed, what type is it?
V-Belt Motor Mount Arrangement:
Direct Drive Design:
Other Information • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Will this pump replace an existing pump?
If this pump will replace an existing pump, complete the next seven questions. If no, go to "Describe Operational Problems."
Manufacturer:
Size/frame:
Motor HP:
Pump RPM speed:
Discharge position:
Impeller diameter:
Describe operational problems: (Space limited to 300 characters.)
Comments: (Space limited to 300 characters.)