Company Name:
*
Contact Name:
*
E-mail:
Address:
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:
Application:
Your Current Supplier:
Sample Prototype(s) Required By:
Estimated Annual Usage:
*
Target Net Price:
*
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