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: