ltworderform

Specificaton Selection

Select your options from the below pull down menu's. An example of a part number would be :

LTW-2-1.75-4.5-0.50-0.26 - List Price : $158.00 Typical Resale Price : $118.50

LTW - 2 (2" tri-clamp connection) - 1.75 (1.75" "C" dimension) - 4.5 (4.5" insertion length) - 0.50 (0.50" diameter) - 0.26 (0.26" bore)

Select Cap Size : *

Select "C" Dimension : *

Select Insertion Length "U" :

Select Diameter "Q" :

Select Bore Size "B" :

For alternate configurations, consult the factory.

Company & Shipping Information

Full Name: *

Company Name :

First Name :

M.I. :

Last Name :

Phone #:

( )

Address

Street Address

Address continued

City

State

Zip

Shipping Method

UPS

Fed Ex

Please Enter Your UPS Number Or We Will Include Shipping In The Final Price :

Payment Information

Enter Your Lumenite® Account Number :

Please Note : If you do not hve a Lumenite® account and would rather pay by credit card or check, please check a box below.

Select One : Master Card / VisaCheck