Please fill in as much of the information listed below as you can.

**This Form is for Information on Industrial Generators Only (20kW and above), Not RV Generators, Portables or Engines.

I. Personal information 

    1. Company Name:

    2. Person to Contact: *

    3. Phone Number: *

    4. Fax:

    5. E-mail: *

    6. US Postal Address:  *    
                                            

    7. City: *

    8. State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY *

    9  Zip Code:  *

   10. Check here if you would like a site inspection. (MI, OH, & Western PA sites only)

II.  Generator Information

    1. Required size (if known): kW.

            1b.If you do not know the size please tell us what you plan to power.

            Type a list of equipment that will be powered by the generator. Another helpful piece of information is the peak utility usage information from your electric bill for the hottest month of the summer.

    2. Generator Voltage: Choose one 120/240, 1 phase, 60Hz 120/240, 3 phase, 60Hz 120/208, 3 phase, 60Hz 277/480, 3 phase, 60Hz Other

    3. Type of Fuel: Choose One Diesel Natural Gas LP Vapor LP Liquid

            3b. If Diesel Fuel Is Used, What size Fuel Tank: None 8 Hour 12 Hour 24 Hour Custom

    4. Application: Choose One Commercial Industrial Health Care Residential Other

    5. Type of Control: None Analog - Detector 12 Digital - PCC

    6. This Generator Will Be Installed: Choose One Indoors Outdoors

III.  Optional Equipment/Notes:

    1. Automatic Transfer Switch: No Yes

        1b.If You Want A Transfer Switch, How Many Amps: Amps       

      2.  If You Have Any Special Requests or Questions, Please Feel Free To Write Them In The Space Provided Below.

Thank you for using our online submittal request form.  After reviewing your information, please click the submit button below and a Cummins Bridgeway representative will contact you.