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SolidCold Sales and Rental Request

  * denotes required field    
* Company/Institution: We Accept Credit Cards
Type of Industry:
* Contact Person:
* Contact Phone:  
* Email:
* Service Address:
* City:  
* State:  
* Zip Code:  
Transaction Type:  
* Type of Equipment: If other, specify in comments  
* Temperature Range: If other, specify in comments  
Model Number:  
Number of Units:      
CO2/LN2 Back Up System? Yes No      
Remote Temperature
Monitoring System?
Yes No      
Comments, Questions
or Specific Instructions:
* Please enter the characters exactly as they appear
       

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