FX-1500 Quote Form

Sensor Style (*Selection Required)
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What target gas or gases do you want to monitor? (*Selection Required)
*Ammonia	Please select a valid item.Please select an item.
*Carbon Monoxide	Please select a valid item.Please select an item.
*Chlorine	Please select a valid item.Please select an item.
*Chlorine Dioxide	Please select a valid item.Please select an item.
*Hydrogen	Please select a valid item.Please select an item.
*Hydrogen Chloride	Please select a valid item.Please select an item.
*Hydrogen Cyanide	Please select a valid item.Please select an item.
*Hydrogen Sulphide	Please select a valid item.Please select an item.
*Nitrogen Dioxide	Please select a valid item.Please select an item.
*Nitric Oxide	Please select a valid item.Please select an item.
*Oxygen	Please select a valid item.Please select an item.
*Ozone	Please select a valid item.Please select an item.
*Sulphur Dixide	Please select a valid item.Please select an item.
*Cable Length		Please select a valid item.Please select an item.

AC Power Supply (*Selection Required)
*Select AC Power Supply Type	Please select a valid item.Please select an item.
Accessories (*Selection Required)
	4-20mA Retransmitter
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	Battery Backup
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	Spare Sensor Quotation will include all target gas types selected above
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	Calibration Gas Quotation will include all necessary target gas and accessories selected ablove
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	FX-400 Telephone Dialer
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	Internal Mount Data Logger
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General Information (*Selection Required)
*Type of Process	Please select a valid item.Please select an item.
*Request Action	Please select a valid item.Please select an item.
*Contact Form	Please select a valid item.Please select an item.
*Information Required
*Company Name	A value is required.Minimum number of characters not met.
*Contact Name	A value is required.Minimum number of characters not met.
*Address	A value is required.Minimum number of characters not met.
*City	A value is required.Minimum number of characters not met.
*State/ Province	A value is required.Minimum number of characters not met.
*Zip Code	A value is required.Minimum number of characters not met.
*Country	A value is required.Minimum number of characters not met.
*E-Mail Address	A value is required.Minimum number of characters not met.Invalid format.
*Telephone Number	A value is required.Minimum number of characters not met.
FAX Number
Special Request