Glands and Seal Kits Quote Request

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Company Information

Company Name (required)

Contact Name (required)

Your Email (required)

Telephone (required)

Street Address (required)

Mailing Address (leave blank if same as above)

City (required)

State (required)


Cylinder Information

Cylinder Description

Cylinder Type

Cylinder Fluid

Cylinder Part Number (Model or Serial Number)

Gland/Seal Kit Information

Gland/Seal Kit/Seal Number

Sample Available?

Quantity Needed

Requested Due Date (For rush jobs, please call 260-833-6374.)

Seal Material
UrethaneBuna rubberHigh temp vitonOther (Please describe in comment box below)

Seal I.D. Size

Seal O.D. Size

Seal Height (lying flat)

Please leave any special requests, comments, or questions.