Form

E-mail Address: *
REQUEST FOR:
QUOTE:
MORE INFO:
PLACE ORDER:
Company Name: *
Contact Name: *
Title: *
Telephone: *
Mobil:
IF PLACING AN ORDER, ENTER PO#: (Sales will contact you to confirm order details, payment and provide lead time)
TELL US WHAT YOU ARE LOOKING FOR (check all that apply):
DISPENSER SYSTEM:
2 Gallon Manual Pump:
5 Gallon Manual Pump:
Manual Pump - Other Capacity:
HD Cowl/Thrust Reverser Pump:
Standard Cowl/Thrust Reverser Pump:
Landing Gear Service Unit:
Transfer Pack:
Bung Kit:
HOSES:
7 ft:
15 ft:
25 ft:
Other Length:
SEAL KITS:
Viton/VFKM:
EPDM:
FILTERS:
3 Micron:
10 Micron:
Water Stop:
TOTALIZERS:
Liters:
Quarts:
IDENTIFY THE FLUID TYPE: (seals will be matched to fluid type):
2197:
2380:
5606:
Castrol Aero 35:
Castrol Aero 40:
CSD/IDG:
Engine Oil:
Hydraulic:
HiJet IV:
Mobil 254:
Mobil Jet II:
Skydrol:
MIL SPEC/Other:
OTHER QUESTIONS, SPECIFICATIONS OR EQUIPMENT REQUESTS:



* Required

If you would like to submit the request by Fax, select the “Print” button and Fax to: 952-997-3658
For more info, contact Sales at 954-803-7519 or email us: info@fluidtran.com