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1801 Falls Ave. Waterloo, IA 50701
319-233-6101
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Request for Quote or Part
Request for Quote or Part
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WBC Employee Information
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Last
Date of Request
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MM slash DD slash YYYY
Job #
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Job Status
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Urgent - Order Part Overnight - WBC Install
Regular Delivery - Order Part - WBC Install
Requesting Part Pricing - Customer Follow-up
Job Estimate
Customer Information
Customer
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Contact
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First
Last
Phone
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Email
Job Location
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Job Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Description of Work or Parts Needed
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Max. file size: 300 MB.
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Multiple files can be uploaded.
Drop files here or
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Max. file size: 300 MB.
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Comments
Equipment Information
Please provide information about the equipment that relates to the part(s) or service needed for this request.
Equipment Manufacturer
(Required)
Equipment Model Number
(Required)
Equipment Serial Number
(Required)
Retube Information
Tube Count
Tube Length
Feet
Inches
Tube Diameter - in
Retube Notes
Motor Information
Motor Manufacturer
Motor Serial Number
Motor Model Number
Voltage
Select One
110
208
220
240
Other
P.H.
Select One
1
3
Other Voltage
H.Z.
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60
50
H.P.
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1/4
1/3
1/2
1
2
3
4
5
6
7
8
Other
Other H.P.
RPM
Select One
1724
3450
Other
Frame
Other RPM
Motor Notes
Pump Information
Pump Manufacturer
Pump Model Number
Pump Serial Number
GPM
Pump Size - in
Piping Size - in
Feet of Head - PSI
Pump PO #
Pump Notes
Operating System
System Type
Select One
Steam
Hot Water
Gas Pressure
Gas Pressure - select one
PSI
inches
Maximum System Pressure - PSI
Operating Pressure - PSI
Relief Valve - MFG #
Relief Valve - Size - in
Relief Valve - BTU/hr
Relief Valve - lbs/hr
Valve Type
Select One
System Relief Valve
Boiler Relief Valve
Operating System Notes
Any additional information about this part or service request?
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