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Please note that fields marked in bold text are required.

Please provide the following contact information:

Contact Name:
Company Name:
Phone:	()- x
Fax:	()-
E-mail:
Date Quote Required:

Total Rating:	kW  kVA
Input Rating:

Input Rating Voltage:
Input Rating Current:
Input Rating Phase:	SingleThreeThree-Two

Frequency:	50 Hz60 Hz50/60 Hz	If other, please specify
Number of Output Tones:	12345Other	If other, please specify

Output Range of Each Zone:
Voltage:	AC   DC

Current Output:
Phase Output:
Type of Control:	LocalRemoteNone

SCR:	4-20 mA0-10VManual Pot	Primary    Secondary
Saturable Reactor:	0-90 VDCOther	Primary    Secondary

Other Saturable Reactor:

Variable Transformer:		Primary    Secondary
Tap Switch:		Primary    Secondary

Transformer Rating:

Construction Material:

CopperAluminumCopper/AluminumAluminum/Copper

Max. Ambient Temp:	40Other	If other, please specify
Insulation Class:	220200180Other	If other, please specify

Cooling:

Air by ConvectionForced Air CooledWater-Cooled

Primary Configuration:	DeltaWyeScott TOther	If other, please specify
Voltage:		Taps:	+/- 5 percent+/- 10 percent
Secondary Configuration:	DeltaWyeScott TOther	If other, please specify
Enclosure Rating:	NEMA 1NEMA 3RNEMA 4NEMA 12
Voltage:		Taps:	+/- 5 percent+/- 10 percent

Color Paint:

Warner Power GrayGray PrimerOther

If other, please specify

Input Options:	Disconnect	Not Fused	Fused
	Fuses	Aux. Switch	Contactor
	CircuitBreaker	UVR	ShuntTrip

Application:
Comments:
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