Request For Quote: Rubber & Plastic Extrusions & Moldings

Customer Information

Name*:
Job Title*:
Phone*:
Email*:
Website:
Fax:
Company Name*:
City*:
State:
Country*:

Project Identification

Customer Part Number
   
Part Description*:
* For PrototypeFor Production

Quantities and Pricing

Annual Usage*
Target Price (USD$) *
Units*

Procurement Requirements

Target Timeline to Receive Production
PPAP Required?*
PPAP Level
Package and Shipping Requirements*
Case Quantity Preferred
Units

Physical Specifications


Project Artifacts Available to Upload
 Physical Samples  Other Documents
 Test Jig  Picture(s)
 Mating Piece  2D Print(s)
 Accessories  3D Part File(s)


Please upload any available files
Additional Information (Material type, adhesive requirements, specific functions, comes in contact with etc...)

Fairchild Industries, Inc.
475 Capital Drive
Lake Zurich, IL 60047
Phone: 847.550.9580
Fax: 847.550.9585

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