Customer Name M/s Date:

Address
Contact no
E mail id

Application Transfer/feeding/processing
Process involve
Liqiuid name
Flow required
Head Meters
Discharge pressure
Suction condition Flooded/Negative lif
Suction pressure
NPSHA
Viscosity
Sp garvity
Ph
Temperature
Qty required
Pump orientation required Horizontal/vertical/Trolley type
Daily operating Hours
History if facing any problem or earlier type of pump using details
Offer required Firm/Budgetary/project base
Scope of supply Bare pump+flange+coupling+Geared Motor+Base frame