Quote Form 103

Single Plain Brush Box

Common Applications: Foreign Motor Manufacturers, DC Commutator Motors & Generators, Slip Ring, Radial Carbon Brush Holder

Please fill out as completely as possible

Name(Required)

First Last

Company(Required)

Account Number

Email(Required)

Phone(Required)

Street Address

Address Line 2

Address(Required)

City * State / Province / Region * ZIP / Postal Code * Country *

Manufacturer

Power

Power Type

Applications

Primary Volts

Primary Amps

RPM

Sec/Exc Volts

Sec/Exc Amps

Type

Model

Frame

Brushes/Set

Brush grade/markings

Brush Part #

Holder Part #

HQD/Wear Device

HQD

Wear Device

Units

mm

inches

Reference the image below for assistance with the following fields

Brush Box Thickness

Overall Width

Brush Box Width

Reference the image below for assistance with the following fields

Brush Box Length

Serrations

Photo/Document Upload

Maximum 3 Files

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 256 MB, Max. files: 3.

Would you like us to quote brushes as well?

Yes

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Quote Form 103

Single Plain Brush Box

Reference the image below for assistance with the following fields

Reference the image below for assistance with the following fields

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Industries

Resources

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