©PROPOSAL INPUT FORM

Fax completed form to +800.297.5644

Customer:

Contact:

Address:

Phone:

City, ST, Zip:

Fax:

Equipment Location:

Email:

Type, Size & Mfr. of Equipment:

       ROI:  ____Yes  ____No                                  Use one input form for each system to be quoted.               

Number
Size
Type of Line  (See below*)
     
     
     
     
     
     
     
                                        
*Lines Needed For Each Type Equipment
Cooling System  Return to tower; Supply(s) to Condenser/Heat Exchanger(s); Make Up Line(s)
Boiler System Horsepower; Supply Line to Boiler; Make Up Line; Condensate Return Line(s)
Air Wash System Supply to Air Washer; Return to Chiller; Make Up at Sump
Also Supply Lines to any additional equipment i.e., Air Compressors; Mold Machines, By-Pass, etc


Cooling System ROI Input Information
Complete information is necessary for ROI.             

Yearly Operating Hours:

  

System Tonnage:

Number

HP

Water Cost per 1000 gal.:

  

Cooling water circulating pump(s) rating

    

Sewer Cost per 1000 gal.:

      

Power Cost per KWH:

  

Tower Fan Motor(s) rating

    

Annual Chemical Costs:

  

Chill water pump(s) rating