Quote Sample Request - Automotive Industry

• Name
• Company Name

• Address
• City

• State/Prov (US & Canada) Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Delaware Connecticut Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territory Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming Yukon Territory
• Zip / Postal Code

• Phone
• Fax
• Email Address

To help us better understand your needs, please provide the following information.

• Application
• Industry Finishing HVAC General Industrial Other

• Do you need a cap or plug?

  Cap Plug Other

• What is the outside dimension of the part you want to cap?

• What is the inside dimension of the part you want to plug?

• What color do you desire for this part?

• Estimated Annual Usage < 1,000 parts a year 1,000 - 4,999 parts a year 5,000 - 9,999 parts a year 10,000 - 24,999 parts a year 25,000 - 49,999 parts a year 50,000 - 99,999 parts a year 100,000 - 499,999 parts a year 500,000 or more parts per year

• How did you hear about us?

  Online News Article I had a catalog I'm currently a customer Trade Show I received an email Other

If you found us on the Internet, how?

• Online Internet Directory Thomas Register PowderCoating.org Other
• Search Engine Google Bing Yahoo AOL Other

• If you found us through a referral, please let us know if one of these applies.

  from associate/colleague within my company from associate/colleague outside of my company from previous experience with your company other

• If you wish to include an image with your request, add the image here: (1 file @ 100 MB max)

• Comments: