BORE SPACER REQUEST FOR QUOTATION Initiated by: Date: Quote needed by: NOTE: IT IS IMPERATIVE THAT ALL THE INFORMATION ON THIS FORM IS PROVIDED FOR US TO DESIGN A CUSTOM SPACER TO EFFECTIVELY MEET YOUR NEEDS, AND ALSO TO PROVIDE YOU WITH AN ACCURATE QUOTATION Customer Information Company Address City State ZIP Code Contact Name * Title Telephone * Fax Number Email Address * Casing Information Length of casing run Quantity of spacers needed Casing inside diameter Casing wall thickness Spacer centers in bore What is casing going under? Casing outside diameter Casing material Duct Information NOTE: THIS FORM ACCOMMODATES SPACERS REQUIRING UP TO 4 DIFFERENT DUCT SIZES / TYPES. FOR GREATER NUMBERS, PLEASE CONTACT FORMEX MANUFACTURING. Duct Size 1  Duct size (nominal) Type of duct/material Number of each duct size Duct Size 2  Duct size (nominal) Type of duct/material Number of each duct size Duct Size 3  Duct size (nominal) Type of duct/material Number of each duct size Duct Size 4  Duct size (nominal) Type of duct/material Number of each duct size Minimum Dimensions NOTE: IF YOU DO NOT SPECIFY MINIMUMS, AS SOME CUSTOMERS DO NOT, WE WILL USE OUR STANDARD MINIMUM SEPARATIONS. MINIMUM REQUIRED DIMENSIONS DUCT OD - DUCT OD MINIMUM REQUIRED DIMENSIONS DUCT OD - SPACER OD MINIMUM REQUIRED DIMENSIONS DUCT OD - CASING ID MINIMUM REQUIRED DIMENSIONS SPACER OD - CASING ID Will the casing be filled? What will the fill material be? Does the spacer require an opening for a fill hose? If yes, what is MIN DIA? Is the application for communications, power, both, or other? Should the spacer be quoted with optional low profile caster assemblies? Other pertinent information: