Request for Quote

Please print out this form and fax it to Dayton Gear at (937)-866-0408

Background Information

Company Name_____________________________________________________________

Contact Name_______________________________________________________________

Phone_______________________________     Fax_________________________________    

Street Address 1____________________________________________________

Street Address 2____________________________________________________

City: ________________________ State____________________  Zip Code_____________

E-Mail______________________________________

Gear Data

Gear Type: Spur__ Helical__ Other__________________________

Quantity____________  Date required________________________

Number of Teeth______ Pitch: DP_______CP______Mod________

Pressure Angle______ degrees

Material_____________________  HT________________________

Outside Diameter______inches______MM   Pitch Diameter______inches_______MM

Face Length_____inches______MM      Length thru Bore_____inches______MM

Bore_______inches______MM          Counter Bore______inches_______MM

Hub Diameter (1)______inches______MM     Projection______inches______MM

Hub Diameter (2)______inches______MM     Projection______inches______MM

Keyway_______________________________________________________________

Set Screws____________________________________________________________

AGMA Class_________________________

Notes____________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

USE SPACE BELOW TO PROVIDE A ROUGH SKETCH OF GEAR CONFIGURATION...