RFP Form

First Name Last Name Company Name Phone Date

Address Address line 2 City State Zip Email

Heat Exchanger or Chiller Heat Exchanger Water Cooled Chiller Air Cooled Chiller

Coolant Fluid Unit Capacity Coolant Flow Rate Coolant Pressure Coolant Temperature Coolant Pressure Control

Filtration for Coolant? Yes No

Enter Micron Maximum Size

Special Flow Meters Needed? Yes No

Do you require special controls, lights, relays, etc.?

Quote Info

Are CE, UL, or CSA certifications required for this unit? CE UL CSA

Quote Quantity Annual Production Requirement

Check all that apply End User OEM Consultant University Other

Any additional information