Quote Form 110

Bar Mount (Beveled Carbon Brush Holder)

Common Applications: GE, Reliance, Imperial, Baldor, US Motors, DC Commutators Motors & Generators

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

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Brush Box Thickness

Brush Box Width

Overall Width

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Terminal Size

Mounting Bolt Size

Mounting Surface To Brush Box

Bottom Angle

Brush Box Length

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 110

Bar Mount (Beveled Carbon Brush Holder)

Reference the image below for assistance with the following fields

Reference the image below for assistance with the following fields

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