Name:
Company:
Phone:
E-mail:
 
Billing Street:
Billing City:
Billing State:
Billing Zip:
 
Check this box if the shipping and billing addresses are the same.
Shipping Street:
Shipping City:
Shipping State:
Shipping Zip:
 
Requested Lead Time:
Part Number:
Quantity:
 
Will customer supply
DXF/DWG ?
Yes  No
1st Article required? Yes  No
Part Description:
Tolerances given:
 
Material Type:
Thickness or Gauge:
Material Certs required? Yes  No
Customer Supplied Material? Yes  No
 
Customer deburring requirements:
Finish (other than raw materials): Powdercoated  Plated
Other  
 
Ship Via: Our Truck  Will Call
FedEx Ground
Other  
Accept over/under: Yes  No
  Quantities : 
Packaging concerns/instructions:
 
File Upload:  (Please zip .dwf and .dwg files)