QUOTATION REQUEST

Name:

Company:

Address:

City, State, Zip:

Telephone:

Fax:

e-mail:

APPLICATION

Horsepower:

Model:

Manufacturer:

Type:

Power Source TypeGasDieselElectric

Idle Speed:

Loaded Speed(Max):

Loaded Speed(Min):

Torque Required:

Shaft Diameter:

Shaft Length:

Inboard/Outboard:

Mounted On:

Mount TypeCrankshaftJackshaftFlywheelGear ReductionRatio

Pulley (No. of Grooves):

Pitch Diameter:

Chain(No. of Teeth:

Bearing Desired:

Bearing TypeBallNeedleBushing

Purpose of Clutch:

Clutch TypeSoft StartSpeed ControlOverloadBrakeGovernor

Service:

Service TypeIntermittentContinuousSteadyShock LoadLight DutyHeavy DutyIdle TimeCyclesNo. Starts

Other Comments:

Clutch Series Desired:

Prototypes Required:

Quantity: