Jesco Products Company, Inc.
Manufacturer of Precision Meter, Mix, Dispense and Pumping Equipment
Request for Quotation

Please provide the following information. It is required in order to recommend and quote the best dispensing equipment for your application. If you have any questions, or need assistance in completing this form, please call us at (586) 254-6610. If you prefer, send us the contact information and a brief description of your application. A Jesco sales representative will contact you shortly after your submission in order to assist you.


Contact Information


*Name

Title

*Company

*Address

*City

*State

*ZIP

Country

*Phone:

Fax:

*E-mail:

*How did you hear about us?:

* Required Field


Brief Application Description


Please provide a brief description of your application/process


Specific Application Information


Number of Components

if other, specify

Type of Material

if other, specify

Application Type

if other, specify

Dispense Method

if other, specify

Dispense Type

if other, specify

Machine Type

if other, specify

Mixer Type

Minimum Shot Size

Maximum Shot Size

Minimum Flow Rate

Maximum Flow Rate

Precision Bead Size (A typical example is filled in the box)

Precision Bead Total Length


Production Requirements


Production Schedule

Production Rate

Parts per


Time allowed to dispense

Time allowed to index part

Total Cycle Time


Fluid Specifications


Name of Fluid Manufacturer

Contact Name

Contact Phone

E-mail

Fax


Part A-Resin

Part B-Catalyst

Fluid Name

Fluid Product Number

Mixing Ratio by Volume


Parts to


Parts to

Mixing Ratio by Weight


Parts to


Parts to

Viscosity @ 77F

cP

cP

Mixed Viscosity @ 77F (25C)

cP

Work Life Mixed

Final Cure Time

Processing Temperature

F

F

Viscosity at Processing Temp

cP

cP

Specific Gravity or Density

Filler Type

% by wt.

% by wt.

Supply Container Size

Is Heating Required? If yes, to what temp?

F

F

Agitation Required?

Thixotropic?

Abrasive?

Moisture Sensitive?

Corrosive?

Vacuum Degassing Required?

Filtration Required?

Clean-Up Solvent?


Applicator Valve


Applicator Valve Type

if other, specify:

Applicator Valve Actuator?

if other, specify:

Dispense Valve Mounting?

if other, specify:


Utilities Available


Electrical Power

volts

phase

Hz

Pneumatic Power

psi

cfm


Other Information


Specify any additional Information, Specifications or Standards that are important to accurately complete this quote. Specify any optional equipment and/or features also required such as: supply pumps, pump hook-ups, dispensing motion, system integration, training, etc.