COMPANY INFORMATION

---

Quotation Due Date:
Company: 
Address:   
City:    State: Zip:
Phone:    Fax:
Email:   

ENGINEERING CONTACTS

---

Name/Title:
Phone/Ext.:

Name/Title:
Phone/Ext.:     

PURCHASING/OTHER CONTACTS

---

Name/Title:
Phone/Ext.:

Name/Title:
Phone/Ext.:

Sales Manager:
Sales Rep.:   

Product:
Cust. P/N & Rev:
Product Application:

Customer Documentation Provided:

  

Proto Qty:    
Annual Qty:   
Release Qty:  
Price Target:

BASIC PRODUCT REQUIREMENTS

---

Operating Conditions:
Temperature: Humidity:

Storage Conditions:
Temperature: Humidity:

Overall Part Dimensions:

Stiffeners/Backers/Adhesives, Etc.:

Bend Radius: # of Cycles:
Bend Location(s):
Material Thickness: Type:
Connector/Interface Type:
Pitch:
Die Cut Tolerance: 
LCD Attach/Pitch:  

Assembled Components: Yes No
If yes, please provide details:


Consigned Purchased

Current/Voltage Requirements: 
Minimum/Maximum Resistance(s):

INK TYPES

---

PFC:   Customer: 

Graphic Ink Requirements:

Regulatory Requirements (UL, FDA, ETC.):

Special Requirements:

NOTES: Requirements: Mechanical drawings with dimensions, tolerances and installation information and a schematic, wire list or sketch showing electrical connections. Attach component information (BOM, specifications and costs), customer information and graphic ink color specifications as required.

A credit application is required for new accounts (not required for estimates.)