ELECTRIC HEATERS FOR INDUSTRY
Process Heater Quotation Form
Please use this form to request a quotation for our Process Heaters. Pleae make sure you complete the fields marked with asterisks to produce a quotation for you without delay.
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data-toastr-position="top-right" - toastr message position:
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php/contact.php - action form required to be pointed here!
NOTE: Add .required class for required fields.
All input elements name required to be array format: contact[first_name], contact[last_name], etc
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<form class="validate" action="php/contact.php" method="post" enctype="multipart/form-data" data-success="Sent! Thank you!" data-toastr-position="top-right">
<fieldset>
<!-- required [php action request] -->
<input type="hidden" name="action" value="contact_send" />
<div class="row">
<div class="col-md-6 col-sm-6">
<label>Name *</label>
<input type="text" name="contact[name]" value="" class="form-control required">
</div>
<div class="col-md-6 col-sm-6">
<label>Company Name *</label>
<input type="text" name="contact[Company_name]" value="" class="form-control required">
</div>
</div>
<div class="row">
<div class="col-md-6 col-sm-6">
<label>Telephone *</label>
<input type="number" name="contact[telephone]" value="" class="form-control required">
</div>
<div class="col-md-6 col-sm-6">
<label>Email</label>
<input type="email" name="contact[email]" value="" class="form-control">
</div>
</div>
<div class="row">
<div class="col-md-12>
<label>Address *</label>
<input required type="text" value="" class="form-control" name="contact[address][required]" id="contact:address">
</div>
</div>
<div class="row">
<div class="col-md-12" >
<label>Project Name *</label>
<input required type="text" value="" class="form-control" name="contact[process_medium][required]" id="contact:process">
</div>
</div>
<div class="row">
<div class="col-md-3 col-sm-3">
<label>Quantity *</label>
<input required type="text" value="" class="form-control" name="contact[quantity][required]" id="contact:quantity>
</div>
<div class="col-md-3 col-sm-3">
<label>Process Medium *</label>
<input type="text" name="quote[process_medium]" value="" class="form-control required">
</div>
<div class="col-md-3 col-sm-3">
<label>KW Required</label>
<input required type="text" value="" class="form-control" name="contact[kw_required]" id="contact:kw">
</div>
<div class="col-md-3 col-sm-3">
<label>Heater Type</label>
<input required type="text" value="" class="form-control" name="contact[heater_type]" id="contact:heater">
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Flow Rate: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[in_flow_rate][required]" id="contact:inflow">
<span class="input-group-addon">kg/hr</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Flow Rate: *<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[out_flow_rate][required]" id="contact:outflow">
<span class="input-group-addon">kg/hr</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN Temperature: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[in_temperature][required]" id="contact:intemp">
<span class="input-group-addon">°C</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Temperature: *<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[out_temperature][required]" id="contact:outemp">
<span class="input-group-addon">°C</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Pressure: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[in_pressure][required]" id="contact:inpressure">
<span class="input-group-addon">bar</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Pressure: *<span class="anote"><</span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[out_pressure][required]" id="contact:outpressure">
<span class="input-group-addon">bar</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Specific Heat: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="text" value="" class="form-control" name="contact[in_specific_heat][required]" id="contact:inspecific">
<span class="input-group-addon">kJ/kg°C</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Specific Heat: *<span class="anote"></span></label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[out_specific_heat][required]" id="contact:outspecific">
<span class="input-group-addon">kJ/kg°C</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Density<:</label>
<div class="input-group"<>>span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[in_density]" id="contact:indensity">
<span class="input-group-addon">kg/m³</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Density:<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[out_density]" id="contact:outdensity">
<span class="input-group-addon">kg/m³</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Viscosity:</label>
<div class="input-group"><span class="anote"></span>
<input required type="text" value="" class="form-control" name="contact[in_viscosity]" id="contact:inviscosity">
<span class="input-group-addon">bar</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Viscosity:<span class="anote"></span></label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[out_viscosity]" id="contact:outviscosity">
<span class="input-group-addon">bar</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Thermal Conductivity:</label>
<div class="input-group"><span class="anote"></span>
<input required type="text" value="" class="form-control" name="contact[in_thermal_conductivity]" id="contact:inthermal">
<span class="input-group-addon">w/m°C</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Thermal Conductivity:<span class="anote"></span></label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[out_thermal_conductivity]" id="contact:outthermal">
<span class="input-group-addon">w/m°C</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>IN - Molecular Weight:</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[in_molecular_weight]" id="contact:inmolecular">
<span class="input-group-addon">kg/mol</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>OUT - Molecular Weight:<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[out_molecular_weight]" id="contact:outmolecular">
<span class="input-group-addon">kg/mol</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>MINIMUM - Ambient Temperature:</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[minimum_ambient_temp]" id="contact:minambient">
<span class="input-group-addon">kg/hr</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>MAXIMUM - Ambient Temperature:<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[maximum_ambient_temp]" id="contact:maxambient">
<span class="input-group-addon">kg/hr</span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>Corrosion Allowance:</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[corrosion_allowance]" id="contact:corrosion">
<span class="input-group-addon">mm</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label>Design Pressure:<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[design_pressure]" id="contact:designpress">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>Design Code:</label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[design_code]" id="contact:designcode">
</div>
</div>
<div class="col-sm-6 form-group">
<label>Space Limitations:</label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[space_limitations]" id="contact:spacelimit">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6 form-group">
<label>Construction Materials Heater Body:</label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[construction_heater_body]" id="contact:body">
</div>
</div>
<div class="col-sm-6 form-group">
<label>Construction Materials elements:</label>
<div class="input-group">
<input required type="text" value="" class="form-control" name="contact[construction_elements]" id="contact:elements">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Electrical</strong></h2></div>
<div class="card-block">
Electrical Connection Required: *
<br><br>
<div><label class="radio form-control "><input type="radio" name="quote[[connection_star]" value="star"><i></i> Star</label></div>
<div><label class="radio form-control "><input type="radio" name="quote[[connection_star_delta]" value="star_delta"><i></i> Star Delta</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[[connection_delta]" value="delta"><i></i>Delta</label></div>
<div class="row">
<div class="col-sm-6 form-group">
<label<Voltage: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[voltage]" id="contact:voltage">
<span class="input-group-addon">V</span>
</div>
</div>
<div class="col-sm-6 form-group">
<label </div>Frequency: * <span class="anote"></span </div> </label <>
<div class="input-group" </div>
<input required type="number" value="" class="form-control" name="contact[frequency]" id="contact:frequency">
<span class="input-group-addon">Hz </span </div>
</div>
</div>
</div> </div> </div> </div>
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Heater Certification</strong></h2></div>
<div class="card-block">
Heater Certified For:
<br><br>
<div><label class="radio form-control"><input type="radio" name="quote[certification_not_required]" value="not_required"><i></i>Not Required</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[certification_safe_area]" value="safe_area"><i></i>Safe Area</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[certification_hazardous_area]" value="hazardous_area"><i></i>Hazardous Area</label></div>
<div class="row">
<div class="col-sm-6 form-group">
<label>Zone: *</label>
<div class="input-group"><span class="anote"></span>
<input required type="number" value="" class="form-control" name="contact[zone]" id="contact:zone">
</div>
</div>
<div class="col-sm-6 form-group">
<label>Gas Group: *<span class="anote"></span></label>
<div class="input-group">
<input required type="number" value="" class="form-control" name="contact[gas_group]" id="contact:gas group">
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Terminal Box</strong></h2><>
<div class="card-block">
</div>
</div>
<div><label class="radio form-control"><input type="radio" name="quote[terminal_box_not_required]" value="not required"><i></i>Not Required</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[terminal_box_ex_e]" value="Ex e"><i></i>Ex e</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[terminal_box_ex_d]" value="Ex d"><i></i>Ex d</label></div>
</div>
</div>
</div>
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Orientation</strong></h2></div>
<div class="card-block">
</div>
</div>
<div><label class="radio form-control"><input type="radio" name="quote[orientation_not_applicable]" value="not applicable"><i></i>Not Applicable</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[orientation_horizontal]" value="horizontal"><i></i>Horizontal</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[orientation_vertical]" value="vertical"><i></i>Vertical</label></div>
</div>
</div>
</div>
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Control Panel Type</strong></h2></div>
<div class="card-block">
</div>
</div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_type_not_required]" value="not required"><i></i>Not Required</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_type_thyristor]" value="thyristor"><i></i>Thyristor</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_type_contactor]" value="contactor"><i></i>Contactor</label></div>
</div>
</div>
</div>
<div class="col-sm-6">
<div class="card card-default">
<div class="card-heading card-heading-transparent">
<h2 class="card-title bold"><strong>Control Panel Certification</strong></h2></div>
<div class="card-block">
</div>
</div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_certification_not_required]" value="not required"><i></i>Not Required</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_certification_hazardous_area]" value="hazardous area"><i></i>Hazardous Area</label></div>
<div><label class="radio form-control"><input type="radio" name="quote[control_panel_certification_safe_area]" value="safe area"><i></i>Safe Area</label></div>
</div>
</div>
</div>
</div>
</fieldset>
<div class="row">
<div class="col-md-12">
<button type="submit" class="btn btn-3d btn-teal btn-block mt-30">
SUBMIT
</button>
</div>
</div>
</form>