OTC |NORD Enquiry Form

NORD ENQUIRY FORM

Date :

Your Reference # :

Company:

Company Sector :

Address:

Country:

City :

Name :

Designation :

Phone # :

Department :

Email :

Fax :

Cell # :

Contact Person :

Type :

Power :

Output RPM:

Service Factor :

Mounting Position:

Shaft Rotation:

Break (Yes/No)

Back Stop(Yes/No)

Other Requirements