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

    ”Perry

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