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Your Name(*)

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Your Company(*)

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Your Email(*)

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Your Phone(*)

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Preferred Method of Contact(*)

Email

Phone

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What system are you interested in?(*)

If you selected E:Count Stand Alone, which printer do you want? (Or skip to next question).

Epson Slip

Citizen Thermal

MID:COM

Epson Thermal

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What products are you delivering?(*)

Petroleum products (diesel, gas, kero, etc.)

Propane

Other

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How many meters are on the truck?(*)

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What brand and model of meter(s) are on the truck?(*)

If your meter was not listed or you selected "Other" please specify your brand and model

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Do you require electronic temperature compensation?(*)

Yes

No

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Does your meter(s) have electronic/optic air or vapor eliminators?(*)

Yes

No

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Does your meter(s) already have an electronic valve(s)?(*)

Yes

No

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If no, what kind of valve(s) do you want us to quote?

Single Stage Security (Propane Only)

Two-Stage Aquamatic (Petro Only)

Two-Stage Differential

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Additional Comments

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