On-Line Quote Form / Order Form

Please provide the following contact information, so that we may respond to your quote immediately:

(please be sure not to hit the enter/return key until you have completed this form)

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail

Please provide the following ordering information:

QTY	DESCRIPTION

	BILLING (FOR CURRENT CUSTOMERS ONLY)
Purchase order #
Account name

	SHIPPING
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country

WHEN WOULD YOU LIKE THIS QUOTE? (MM/DD/YY)

WHEN DO YOU NEED THESE PARTS? (# OF DAYS)

IS THERE ANYTHING ELSE YOU THINK WE SHOULD KNOW BEFORE WE QUOTE THIS PROJECT?

ARE WE PROVIDING YOU WITH PRICES FOR A JOB YOU HAVE OR ONE YOU HOPE TO GET?

JOB ESTIMATE

THIS MAY TAKE  20-30 seconds TO

SEND YOUR QUOTE TO US.  THANK YOU FOR YOUR PATIENCE