Product Sample Checklist printable pdf download

PRODUCT SAMPLE CHECKLIST

Bidder Information

1. Name of bidding company? _________________________________________________

2. Mailing Address:_________________________________________________________

3. Email Address:___________________________________________________________

4. Phone number with area code: _______________________________________________

5. Fax Number with area code: _______________________________________________

6. Name of company contact: __________________________________________________

Chemical Product Information (Categories 1-11 or Experimental)

1. Which chemical product category is your chemical to be sold under? __________________

2. What is the name of the product? _______________________________

3. The product is manufactured by ________________________________________________

4. If the product is a liquid what is the percent concentration of the product? _________ %.**

(**This is the Bidder Quoted Concentration NO ranges please. If a range is used, the lowest

bidder specified concentration will be used for cost analysis.)

5. Corrosion inhibited products have a Percent Effectiveness determined to measure the

products corrosion rate on steel. What is the Percent Effectiveness of the Product? ________%

Inhibitor Product Information (Inhibitor Categories A1-A3)

1. Which inhibitor product category is your chemical to be sold under? __________________

2. What is the name of the product? ______________________________________________

3. The product is manufactured by? ______________________________________________

4. What is the finished concentration(s) of the brine(s)? ______________________________

5. What is the percent volume of the inhibitor to be added to the brine(s)? ________________

6. What is the corrosion Percent Effectiveness of the finished product? __________________

7. What temperature class is the product (1 or 2)? _________________________________________

8. If the product is submitted for category A2, what Type is it (I or II)? ________________________

Product Sample Checklist