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• EMAIL TO: sales@bridgeportmagnetics.com Company Name: ___________________________ Contact Name:___________________________ Date:__________ Address:_____________________________________________________ Telephone:__________________________ City:_____________________________ State:_______ Zip:___________ Fax:_______________________________ Email Address: _____________________________________ Website:___________________________ _____________ Application:____________________________________________________________ ___________________________ Customer P/N:___________________________ l New Program l Existing Program Quote Prices on:_________ pcs ELECTRICAL DATA Total Power Rating (VA):______________________Duty Cycle:__________ % Input Voltages: l 100V l 120V l 208V l 220V l 230V l 240V l 277V l Other: _______________V Line Frequency: l 60Hz l 50/60Hz l 400Hz l Other: ______________Hz Thermal Protection: l Auto Resettlable l Non-Resettable Insulation System: l Class A (105°) l Class B (130°) l Class F (150°) PHYSICAL DATA l Not Critical l Maximum Diameter: ________________ l Maximum Height:__________________ • Mounting Method: l Standard Steel Washer/Insulating Padsl Potted Center Drilled Hole or Threaded Insert l Enclosure l Other • Safety Agency Requirements: l ULl CSA l IEC l EN l CE l Medical - Leakage Current_______MA Length Color Length ________Volts P1 Length Color Length ________Volts P2 Length Color Length ________Volts P3 Length Color Length ________Volts P4 l Yes Electrostatic Screen Color Length S1 ______Volts ______Amps AC Length Color Length S2 ______Volts ______Amps AC Length Color Length S3 ______Volts ______Amps AC Length Color Length S4 ______Volts ______Amps AC Length Magnetic Shield l Yes |
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