Preferred Valued Supplier
Made in the USA
Company Name: *

Contact Name: *   E-mail: 


Phone:        Fax Number: 

System Pressure(PSI or Bar)   (Normal):    (Maximum): 

Port Connection: 

Set Point (PSI or Bar)  Rising:    Falling: 

Adjustable Range (PSI or Bar): 

Circuit Form:     SPST-NO(A):   SPST-NC(B):   SPDT(C): 

Electrical:     AC:    DC: 

Amperage:     Resistive:    Inductive: 

Electrical Connection: 

Temperature (°F or °C):     Medium:    Ambient: 

Cycle Rate: 

Other Special Requirements: 


Your Current Supplier: 

Sample Prototype(s) Required By: 

Estimated Annual Usage:    Target Net Price: 

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