Please complete the following form to initiate a Request for Quote



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Please complete the following form to initiate a Request for Quote.
We will respond to your RFQ within 1 business day.

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Products or Systems of Interest:
Please complete the corresponding section of the form for each area of interest.

Filter Bags

Quantity	Bag Type	Micron Rating	Dimensions	Housing Manufacturer

Filters (Vessels or Housings)

Magnetic Separators

Flow Rate	pH	Type of fines	Liquid

Hydro Mags

HM-25 (Air Operated)

E-12 (All Electric)

Liquid Filtration Carts

Filtration Systems

High Pressure Systems
To help us properly determine the system size, please complete as much of this form as possible.

Manufacturer of machine to be fitted:		Year manufactured:


Machine Type:		Model Number:


Spindle Coolant Type:		Spindle Taper Size:


Shank:		Maximum Drill Diameter:


Machine Voltage:		Machine Coolant Voltage:


Is machine equipped for high pressure coolant delivery?


Current filtration on machine:		Micron level:


Tramp oil removal system:

Synergy Applications
1341 West 12th Street Erie,PA,16501 E-Mail: info@synergyapplications.com	Phone: 814 454-8803 Fax: 814 452-6388 Toll-free: 1-800-403-0577

* Preferred means of contact for response?	Telephone	Email	FAX
* Urgency of Application?	Immediate	1 Month	Ongoing