Sales Information Form

Please fill out and hit "Send" a sales engineer will contact you immediately or feel free to in call 517.484.9190 or 1.800.CHILLER.

Name:*

First

Last

Company Name:

Address:

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Phone:*

Area Code

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Phone Number

E-mail:

Specific Application Information

Voltage Available:

Phase:

Hz:

Fluid to be cooled:

Water

Water/Glycol

Oil

If other please clarify:

Chiller to be located:

Indoors

Outdoors

Desired Operating Temperature:

Pump Flow Required(If pump is desired):

Additional Information:

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