The VERAX Compact Flange System
The original and optimal compact flange system. Simple, Safe and Sound
Enquiry Form
     
Partners Contact Information  
     
     






 Please fill in this form. You need to fill every field except "e-mail". This will be
 sent to  eng@verax.biz.You can also download the form in PDF format (this require  Acrobat  Reader) and fax it in to us.


Ref. Nr
Project name:
Type of service:
Pipe: inch DN: O.D:
Wall thickness: mm
  Material:
 
   
Applicable VERAX standard:
   
Operating conditions
Type of fluid:
Pressure: bar
Bending moment: kNm
Axial load: kN
Temperature: °C

Proof test pressure: bar  at °C

  Type of quantity of joints:
Regular:
Blind:
Other:

  Time Schedule:
Preliminary response:
Budget Price:
Firm tender:
Delivery:

  Enquiry issued by:
Name:: Company:
Telephone: E-mail: *
Facsimile:    
Address:


Signed by: Date:


* not required


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