INFORMATION FORM FOR ALL TECHNICAL AND DETAILED REQUESTS PLEASE FILL IN THE FORM BELOW. YOU WILL BE CONTACTED WITHIN 24 HOURS. HEADER INFORMATION STEP 1 / 5 FIRST NAME * LAST NAME * Choose… Sales Purchasing Engineering Research & Development JOB POSITION * COMPANY * Choose… Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of Congo Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia FYROM Falkland Islands (Malvinas) Faroe Islands Fiji Finland France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Georgia & South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe COUNTRY * STATE * CITY * ZIP CODE TELEPHONE FAX EMAIL * WEBSITE Choose… Replacement pump New project Other (please specify) TYPE OF REQUEST * SPECIFY REQUEST TYPE NEXT STEP SYSTEM STEP 2 / 5 SERIES Choose… External Gear Pumps Automotive Environment Peristaltic pumps Food Service Rotary vane pumps Pumps for Hemodialysis Medical Paints and Inks Mosquito misting pumps Continuous inkjet pumps Life Science Pumps for sensor cleaning systems Smart farming Water treatment Cooling pumps for Thermal Management Technopolymer rotary vane pump Other industries Laser cooling pumps INDUSTRY Choose… Circulation Dosing Pressurisation Transfer Special Applications APPLICATION IF OTHER PLEASE SPECIFY FLOW RATE * Choose… l/h GPH l/m GPM ml/rev Oz/sec FLOW RATE UNIT * INLET PRESSURE * * BAR PSI OUTLET PRESSURE * * BAR PSI STATIC PRESSURE * * BAR PSI DUTY CYCLE * CONTINUOUS INTERMITTENT ON OFF SECONDS MINUTES Choose… Direct Magnetic Electro-magnetic (pump integrated with motor) TRANSMISSION * LIFE OPERATING HOURS * INTERNAL RELIEF VALVE YES NO NPSH AVAILABLE BAR PSI SPACE AVAILABLE (UNIT) MM IN SPACE AVAILABLE (HEIGHT) SPACE AVAILABLE (WIDTH) SPACE AVAILABLE (DEPTH) PLEASE ATTACH HYDRAULIC CIRCUIT SCHEMATIC IF AVAILABLE NEXT STEP FLUID STEP 3 / 5 FLUID * VISCOSITY CST CP DENSITY G/CM3 KG/M3 FLUID TEMPERATURE RANGE MIN * MAX * * CELSIUS FAHRENHEIT AMBIENT TEMPERATURE RANGE MIN * MAX * * CELSIUS FAHRENHEIT MAX. PARTICLE SIZE IN DIAMETER (ΜM) (IF THE FLUID IS NOT CLEAN) NEXT STEP MOTOR STEP 4 / 5 In case you supply the motor, please select its characteristics: Choose… None M56 M63 M71 M80 M90 NEMA48YZ NEMA56C Other MOTOR IF OTHER PLEASE SPECIFY Choose… 12V DC 24V DC 100V AC 110V AC 230V AC VOLTAGE * Choose… 50Hz 60Hz FREQUENCY * POLES * SPEED (RPM) * FRAME NEXT STEP OTHER STEP 5 / 5 CERTIFICATIONS REQUIRED ARE YOU REPLACING AN EXISTING PUMP? * YES NO IF YES, PLEASE SPECIFY THE BRAND AND THE MODEL IS THERE ANYTHING WE CAN IMPROVE COMPARED TO THE EXISTING PRODUCT YOU ARE USING? Choose… 1 to 10 11 to 49 50 to 99 100 to 999 +1000 HOW MANY UNITS DO YOU FORECAST TO PURCHASE YEARLY WHEN IN FULL PRODUCTION? * WHEN DO YOU FORECAST THE START OF PRODUCTION? TARGET PRICE Choose… € $ £ -¥ CURRENCY Choose… Immediately Within 3 months 3 to 6 months 6 months 1 year More than one year HOW SOON DO YOU NEED OUR PRODUCT? Choose… Internet Trade fair Word of mouth Seen our product on a machine Other HOW DID YOU HEAR ABOUT FLUID‑O‑TECH? NOTES I authorize the use of my personal data in compliance with the Regulation (EU) 2016/679 (General Data Protection Regulation). Read the Privacy Policy. * SEND CORPORATE THE FLUID-O-TECH WAY WHO WE ARE OUR BRANDS WHERE WE COME FROM OUR VALUES OUR COMMITMENT AWARDS PEOPLE OUR PEOPLE NEWS PRODUCTS PUMPS BY TECHNOLOGY PUMPS BY INDUSTRY PUMPS BY APPLICATION TECHNICAL SUPPORT TECHNOLOGIES FAQ & TIPS WARRANTY REGISTER YOUR PUMP TECHNICAL INSIGHTS CONTACT ITALY - CORPORATE USA - CONNECTICUT USA - CALIFORNIA JAPAN CHINA FOLLOW US P.IVA 08861120965 Fluid-o-Tech Privacy Policy design by Basilico