Name*			Address*
Title			Address
Company*			City*
Phone*			State*
Fax*			Zip*
E-mail*			Country*

Please fill in as many fields as possible - manufacturer standard options will apply unless directed otherwise. To submit the form for the quickest quotation the fields marked with ( * ) should be completed.  N/A, vendor select or unknown are acceptable inputs.  If you have any questions, please contact KECO at 732-901-5900 or keco@optonline.net.
Type of unit required	* Please select Flow meter Flow switch Flow meter with switches
Manufacturer (list any preference)
Model number (if known)
Quantity	*
Tag number - if required, list type and info
Fluid / Media	*
Specific Gravity
Viscosity
Inlet pressure-value and units	* * Please select PSIG Inches H2O Kg/cm2 Bar Other - list with value
Outlet pressure-value and units	Please select PSIG Inches H2O Kg/cm2 Bar Other - list with value Not applicable
Temperature-value and units	* * Please select Degrees F Degrees C Other - list with value
Flow minimum-value and units	Please select GPM GPH SCFM SCFH lbs/min lbs/hr Other - list with value
Flow normal-value and units	* * Please select GPM GPH SCFM SCFH lbs/min lbs/hr Other - list with value
Flow maximum-value and units	Please select GPM GPH SCFM SCFH lbs/min lbs/hr Other - list with value
Line size, schedule, material, liner if applicable	*
Is pipe full?	* Please select Yes No
Connection	* Please select NPT - Threaded RF Flange, 150# RF Flange, 300# FF Flange, 125# FF Flange, 250# Other - please list
Type of meter	* Please select Not applicable Vendor select Positive displacement Turbine Vortex Thermal Density / mass Variable area / Rotameter Open Channel Other - please list
Flow direction	* Please select Not applicable Horizontal Vertical - up Vertical - down Bi-directional
Indicator / readout	* Please select Not applicable None / blind unit Local Remote Local & remote * Please select Not applicable Rate Rate & total Rate & resettable total Total with sweep hand
Indicator display units	* Please select Not applicable GPM GPH SCFM SCFH lbs/min lbs/hr Percentage Gallons Pounds Liters Cubic feet Cubic meters Other - please list
Output signal	* Please select Not applicable None 4-20 mA 4-20 mA with Hart 4-20 mA with Hart & pulse Pulse Other - please list
Available power (if required)
Type of switch	* Please select Not applicable Vendor select Paddle / vane Thermal Ultrasonic Other - please list
Switch contact rating & type (if required or known)
Switch point value (if required)
Deadband for switch point (if known)
Area classification	* Please select Not applicable NEMA 3 NEMA 4 / 4X NEMA 7 IP 65 IP 67 Other - please list

Comments / other available information / special requirements or considerations